Pathology of bilharzial bladder cancer

Retrospective review of bladder carcinoma at this institution has revealed a high incidence of squamous cell carcinoma associated with bilharzia infection as has been found in other Mideast and African countries. Associated inflammatory and epithelial metaplastic changes were commonly noted and apparently represent early changes in the development of carcinoma, particularly in view of the progression from squamous metaplasia to in situ and infiltrating carcinoma observed in both bladder and ureter. The relationship between bilharzia infection and the development of bladder carcinoma has been postulated to be related to several factors; however, as yet the specific etiologic relationship and pathogenesis have not been defined.