Plasmacytoid urothelial carcinoma of the urinary bladder
Dysuria. Three months previously, lower limb deep vein thrombosis. Abnormal cervix examination: tethering in region of left vaginal vault. MRI requested.
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There is abnormal asymmetrical thickening of left posterolateral bladder wall, exhibits restricted diffusion on DWI, when compared to the remainder of the bladder wall, uterus and rectum. There is no resultant hydronephrosis and no associated para-aortic or pelvic lymph node enlargement.
The bladder wall is asymmetrically distorted.
There is transmural involvement and extravesical extension on the T2 and post-contrast images.
Plasmacytoid carcinoma of the urinary bladder or plasmacytoid urothelial carcinoma (PUC) is a rare and only recently described histological variant of urothelial/transitional cell carcinoma.
The MRI features are suggestive of a bladder cancer. There are no definite imaging features to point to a diagnosis of plasmacytoid carcinoma.
There was no metastatic disease spread on MRI, CT or reported on the pathology report following the bladder resection and localized lymph node clearance.
Case presented with
Dr. Navin Ramachandran FRCR
Consultant Uroradiologist UCLH