Effect of schistosomiasis on histopathologic pattern of urothelium in 262 bladder biopsies

ABSTRACT

Schistoscmiasis is a known endemic disease in the Asir region of the Kingdom of Saudi Arabia. Primary urinary carcinoma is the fourth ranked cancer in the Asir region. The current study aims at reviewing the histopathologic pattern of 262 cystoscopic biopsies to evaluate the impact of schistosomiasis on the urothelial lining of the urinary bladder among patients from Asir region. Schistosomiasis was diagnosed in 91 cases [37.7%], non-neoplastic urothelial lesions were seen in 75 cases [29%] and primary bladder cancer was diagnosed in 61 cases [23.3%]. Schistosomiasis was seen in association with 67% of patients with squamous cell carcinoma, 50% of patients with non-neoplastic proliferative urothelial lesions, 20% of patients with adenocarcinoma and only 2.3% of patients with transitional cell carcinoma. Of the 91 patients with schistosomiasis 47 [51.5%] showed associated urothelial lesions of one type or the other while the remaining 44 [48.5%] did not show associated urothelial lesions. The conclusion of the study is that schistosomiasis has an impact on bladder cancer through a series of pre-neoplastic mucosal changes