Presentation
Hematuria.
Patient Data
Solid enhancing mass arising from the right posterior bladder wall above the level of the right vesicoureteral junction and, although it has a bulging of the external bladder contour, does not extend into the surrounding fat planes. No enlarged lymph nodes seen, only a single 7.0 mm lymph node adjacent to the right common iliac vessels. The kidneys are normal in appearance, with no calculi, or hydronephrosis. There is a 4.0 cm cortical cyst in the right middle third that shows a few thin septations and calcifications (Bosniak II). The collecting systems are unremarkable, with no filling defects or strictures are identified. The remainder imaged solid and hollow abdominal viscera are normal in appearances.
Case Discussion
Imaging features are consistent with a bladder tumor, most likely a transitional cell carcinoma.
The patient was submitted to a transurethral resection of the bladder tumor (TURBT).
MICROSCOPIC DESCRIPTION: The bladder biopsy shows features of high grade papillary urothelial carcinoma. The tumor comprises papillae and nests. The tumor cells have enlarged hyperchromatic nuclei and conspicuous nucleoli. Scattered mitoses are present. There is no evidence of lamina propria invasion. Lymphovascular invasion is not seen. Muscularis propria is identified in the biopsy and there is no evidence of muscle invasion.
DIAGNOSIS: TURBT: Non-invasive high grade papillary urothelial carcinoma.
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