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Indian Journal of Pathology and Oncology


Histomorphologic study of cystoscopic urinary bladder biopsies: A gold standard


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Article Type : Research Article

Author Details: Anupama Praveen Gupta*,Anuradha Gupta,Dinkar T. Kumbhalkar

Volume : 6

Issue : 2

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 174

Article End Page : 181


Abstract

Introduction: Urinary bladder lesions pose significant morbidity and mortality throughout the world. Cystoscopy, a widely accepted technique for diagnosing lower urinary tract lesions has its own limitations. Histopathology is gold standard for diagnosing, staging and to assess the microscopic invasion in malignant lesions. Thus present study was undertaken to study bladder biopsies and to correlate cystoscopic impression with histopathology and to know depth of invasion in malignant lesions.
Materials and Methods: It is an observational, prospective study of sixty cystoscopic guided urinary bladder biopsy done at tertiary care hospital over two year period.
Results: Out of total sixty biopsies 19 were non neoplastic (8 inflammatory, 9 metaplastic and 2 immune mediated) and 41 were neoplastic (2 benign, 39 malignant) on histopathology. Non neoplastic lesions (19/60) comprised of 4 follicular cystitis, 2 tuberculous cystitis, 2 eosinophilic cystitis. 4 cystitis cystica, 4 squamous metaplasia, one nephrogenic metaplasia and 2 amyloidosis. Neoplastic group (41/60) comprised of one papilloma, one papillary neoplasm of low malignant potential (PUNLMP), 28 transitional cell carcinoma (TCC), 3 adenocarcinoma, 6 squamous cell carcinoma, one small cell carcinoma and one embryonal RMS. Muscle invasion was detected in 8 and vascular invasion in 2 cases respectively. Cystoscopic impression was non neoplastic and neoplastic in 14 /60 and 46/60 respectively accounting for five discordant cases where final diagnosis was offered on histopathology.
Conclusion: Cystoscopy and histopathological examinations are complementary to each other in evaluating bladder pathologies but histology remains gold standard.

Keywords: Cystoscopy, Urinary bladder, Biopsy, Histopathology, Transitional cell carcinoma.

Doi :-https://doi.org/10.18231/j.ijpo.2019.034