Bladder papillary urothelial carcinoma

Case contributed by Dr Bruno Di Muzio

Presentation

Haematuria.

Patient Data

Age: 84-year-old
Gender: Male
CT

CT IVP

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 tumour, most likely a transitional cell carcinoma

The patient was submitted to a transurethral resection of the bladder tumour (TURBT). 

MICROSCOPIC DESCRIPTION: The bladder biopsy shows features of high grade papillary urothelial carcinoma. The tumour comprises papillae and nests. The tumour 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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Case information

rID: 48119
Case created: 20th Sep 2016
Last edited: 30th May 2017
System: Urogenital
Tag: rmh
Inclusion in quiz mode: Included

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