Urothelial Tumors of the Urinary Bladder in Manipur: A Histopathological Perspective

  • Laishram, Rajesh Singh (Department of Pathology, Regional Institute of Medical Sciences Lamphelpat) ;
  • Kipgen, Paokai (Department of Pathology, Regional Institute of Medical Sciences Lamphelpat) ;
  • Laishram, Sharmila (Department of Pathology, Regional Institute of Medical Sciences Lamphelpat) ;
  • Khuraijam, Sucheta (Department of Pathology, Regional Institute of Medical Sciences Lamphelpat) ;
  • Sharma, Durlav Chandra (Department of Pathology, Regional Institute of Medical Sciences Lamphelpat)
  • Published : 2012.06.30


Objective: To study the histomorphological pattern of urothelial tumors of the urinary bladder in Manipur and to evaluate whether any correlation exists between tumor grade and muscle invasion. Methods: A 10 year retrospective study of all consecutive cases diagnosed in the Department of Pathology RIMS - Imphal, between $1^{st}$ January 2001 to $31^{st}$ December 2010. Results: The study included 26 cases of transitional cell tumors of urinary bladder. The male to female ratio was 1.5:1 and the ages ranged from 38 years to 73 years (medians of 60 and 64 years, respectively). Of the total, 14 (53.9%) cases were low grade, 9 (34.6%) were high grade, 2 (7.7%) were papillomas and 1 (3.9%) was a papillary urothelial neoplasm of low malignant potential (PUNLMP). Pathological staging showed that 14 (53.9%) of the cases were stage PTa, four (15.4%) PT1, and eight (30.9%) PT2. Some 18.2% of low grade tumors and 75% of high grade tumors were invasive to the detrusor muscle layer. Conclusion: Bladder cancer is an uncommon disease, transitional tumors being the only histological type observed. It was more common in males than females, with peak incidence in seventh decade. Most of the tumors were non-invasive (PTa) and invasion to the detrusor muscle layer was seen in more than half of the high grade tumors. There is a definite correlation between advancing tumor grade and muscle invasion.


  1. Ahmed Z, Muzaffer S, Khan M, et al (2002). Transitional cell carcinomas of the urinary bladder. A histopathological study. J Pak Med Assoc, 52, 396-8.
  2. Al-Bazzaz PH (2009). Stage of urinary bladder cancer at first presentation. Saudi J Kidney Dis Transpl, 20, 628-31.
  3. Blaveri E, Brewer JL, Roydasgupta R, et al (2005). Bladder cancer stage and outcome by array-based comparative genomic hybridization. Clin Cancer Res, 11, 7012-22.
  4. Cheng L, Montironi R, Davidson D D, et al (2009). Staging and reporting of urothelial carcinoma of urinary bladder. Modern Pathology, 22, 70-95.
  5. Epstein J I (1999). The lower urinary tract. In: Robbins and Cotran Pathologic Basis of Disease, 8, 974-81.
  6. Grignon D J (2009). The current classification of urothelial neoplasm. Modern Pathology, 22, 60-9.
  7. Gupta P, Jain M, Kapoor R, et al (2009). Impact of age and gender on the clinicopathological characteristics of bladder cancer. Indian J Urol, 25, 207-10.
  8. Hussain NEOS, Shumo AI, Mekki SO, et al (2009). A clinicopathological stydy of urinary bladder neoplasms in patients at three centres in Khartoum, Sudan. Sudan JMS, 4, 249-55.
  9. Kurkure AP (2001). Cancer incidence and patterns in urban Maharastra. Consolidated report of the population based Cancer registries year 2001.
  10. Lynch CF, Cohen MB (1995). Urinary System Cancer, 76, 316-29.
  11. Matalka I, Bani-Hani K, Shotar A, et al (2008). Transitional cell carcinoma of the urinary bladder: a clinicopathological study. Singapore Med J, 49, 790-4.
  12. Ordonez NG, Rosai J (2009). Urinary Tract. In: Rosai J (ed.) Ackerman's Surgical Pathology. 9e, vol (1). St. Louis:Mosby, P.1327-1343.
  13. Population based cancer registry, Imphal, Manipur, National Cancer registry programme, Indian Council of Medical Research (2009). Annual report.
  14. Robbani F, Cordon-Cardo C (2000). Mutation of cell cycle regulators and their impact on superficial bladder cancer. Urol Clin North Am, 27, 83-102.
  15. Rafique M, Javed AA (2006). Clinico-pathological features of bladder carcinoma: experience from a tertiary care hospital of Pakistan. Int Urol Nephrol, 38, 247-50.
  16. Reutor VE (2004). The Urothelial tract: renal pelvis, ureter, urinary bladder and urethra. In: Sternberg's diagnostic surgical pathology. 4thed. Philadelphia: Lippincott Williams and Wilkins, p. 2035-2074.
  17. Waihenya C G, Mungai P N (2004). Pattern of transitional cell carcinoma of the urinary bladder as seen at Kenyatta National hospital, Naorobi. East Afr Med J, 81, 144-19.
  18. Wan J, Grosman HB (1989). Bladder carcinoma in patients age 40 years or younger. Cancer, 64, 178-81.<178::AID-CNCR2820640130>3.0.CO;2-B
  19. Wild PJ, Gield J, Stoehr R, et al (2007). Genomic aberrations are rare in urothelial neoplasms of patients 19 yeas or younger. J Pathol, 211, 18-25.
  20. Yavari P, Sadrolhefazi B, Mohagheghi MA, et al (2009). A descriptive retrospective study of bladder cancer at a hospital in Iran (1973-2003). Asian Pac J Cancer Prevss, 10, 681-83.

Cited by

  1. Differentially Expressed Genes in Metastatic Advanced Egyptian Bladder Cancer vol.16, pp.8, 2015,
  2. Histopathological Study TURBT Biopsies of Urinary Bladder Cancer vol.12, pp.2, 2017,