The Spectrum Of Urothelial Lesions with Clinical, Radiological and Histopathological Correlation in Tertiary Care Hospital

Background: Urothelial lesions, both neoplastic and non-neoplastic, commonly present with haematuria. Urinary bladder cancer, the 10th most common cancer globally, is 90% of urothelial origin. Cystoscopic biopsies and Trans Urethral Resection of Bladder Tumour remain the gold standards for diagnosis, staging, and prognostic evaluation. Methods: This study analysed 100 cases (retrospective, prospective) of all urothelial lesions. Neoplastic cases were classified as per the 2022 World Health Organization classification of urothelial carcinoma and reported as per College of American Pathologists (CAP) protocol. Demographics, clinical history, and radiological data were collected from hospital databases. Descriptive statistics [Frequency, Mean, SD, P-value] was used to depict the baseline profile and clinical diagnosis of all the study participants. Statistical analysis was performed using STATA 14.2. Results: Neoplastic lesions (65%) were more common than non-neoplastic ones (35%), with a male predominance (Male: Female = 5:1) and peak occurrence in the seventh decade (36.92%). Hematuria was the most frequent presentation (81.53%), with smoking being the leading risk factor (36.92%, P=0.021). The most common non-neoplastic and neoplastic lesion were interstitial cystitis (71.43%) and invasive urothelial carcinoma (73.83%), respectively. Radiological and histopathological findings were concordant in 90% of cases. Conclusion: Invasive urothelial carcinoma predominates among neoplastic lesions, occurring in older males with smoking as a significant risk factor. Hematuria remains the primary clinical symptom. Evaluating muscle invasion is critical for prognosis and treatment planning. Radiology and histopathology play a vital role in diagnosis, while immunohistochemistry and molecular studies are essential for precise classification and typing.