Histopathological Spectrum of Urothelial Carcinoma of Urinary Bladder – Study of 160 Cases: Experience in a Tertiary Care Hospital

Introduction: Ninety to 95 percent of urothelial carcinomas occur in the Urinary bladder. The current study aimed to classify urothelial carcinoma based on the TNM AJCC classification 2010 and the WHO 2016 classification system by analysing its histopathological features and correlating them with clinical features and radiological findings. Materials and Methods: 160 cases of all bladder biopsies and TURBT from bladder tumours diagnosed as urothelial carcinoma were observed over a 9-year period. Cystectomy specimens obtained as a follow-up of the aforementioned cases in a tertiary referral hospital. The tumours were examined for histopathological details and they were correlated with clinical characteristics and cystoscopy. Results: Out of the 160 cases that were included, 127 were TURBT and 33 were biopsies. Male preponderance (80.0%) was observed and majority of cases were in the 5th to 7th decade. Gross hematuria (80%) was most common presenting symptom. Infiltrating urothelial carcinoma accounted for 56.9% of all cases. Squamous differentiation was found to be the most prevalent type of divergent differentiation. Muscle invasion was observed in 22 cases (24.17%). Statistical analysis using Chi square tests revealed a significant correlation between tumour size and grade. We received 14 cystectomies specimen from above cases subsequently and the grade, invasiveness and differentiation of the tumour showed concordance with the previous histopathology findings. Conclusion: The study showed uniformity in the diagnosis of the cystectomy specimen with their respective diagnosis on biopsies and TURBT and also emphasized on mentioning a note about the muscle invasion and differentiation of urothelial carcinoma as it has both prognostic and therapeutic implication.