Dr. Danish Sagheer, Dr. Abdullah, Dr. Urooj Aamir, Dr. Muhammad Saad.
Introduction: Urinary bladder carcinoma is the ninth most common malignancy worldwide. Many risk factors have been established, most notably the use of industrial carcinogens and dyes. Papillary Urothelial carcinoma accounts for most of the cases followed by squamous cell and then adenocarcinoma. Objective: To find out various histopathological variants, grading according to WHO, muscle invasion, Lymphovascular Invasion (LVI) and geographical necrosis in patients presenting in Fauji Foundation Hospital, Rawalpindi (FFH, Rwp). Methods: This was a case series study, conducted in FFH Rwp, from January to December 2016. Patients with definitive diagnosis of bladder carcinoma were included in the study. Histopathology report and various demographic variables were recorded. Data was analyzed by using SPS v25. Results: A total of 19 patients presented with bladder carcinoma. Out of 19, 4 were males and 15 were females showing female predominance. Papillary Urothelial carcinoma was the most common finding. 17 patients (89.4%) had low grade Papillary Urothelial tumor whereas 2 (10.6%) patients had a high-grade tumor. Peak age of presentation was in the 6th decade of life. Muscle invasion was seen in 10 patients (52.6%). The muscle was not involved in 9 (47.4%) patients who had a low-grade tumor, indicating most patients present at early or noninvasive stage. Lymphovascular invasion (LVI) and geographical necrosis were found in 4 (21.05%) patients. Lymphovascular invasion was seen more in low grade tumor. Conclusion: Low grade Papillary Urothelial carcinoma was the most common variant encountered in our setting. Almost half i.e. 47.4% patients were in sixth decade of life. Geographic necrosis was associated with high-grade tumors (p-value 0.004) as well as a high incidence of Lymphovascular Invasion (p- value 0.003). Keyword: Bladder cancer, papillary, necrosis, urology, histopathology.