Date of Presentation:2/22/2021

Attending pathologist: Anil Parwani, MD, PhD

Presented by: Bindu Challa, MD

Prepared by: Bindu Challa, MD

Organ:Bladder

HISTORY:

A male in his 70s presented with chief complaint of hematuria. Cystourethroscopy showed normal urethra, occlusive prostate, bladder filled with clots and a large tumor occupying almost the entire bladder. CT urogram abdomen/pelvis showed mass-like thickening of the anterior bladder wall, calyceal diverticulum in superior pole of the left kidney and punctate nephrolithiasis without hydronephrosis.

GROSS:

Received in formalin are numerous fragments of red-tan tissue aggregating to 7.0 cm x 4.5 cm x 3.2 cm.

What is the most likely diagnosis?

  1. Nested Variant of Urothelial Carcinoma
  2. Lipoid-Rich Variant of Urothelial Carcinoma
  3. Invasive urothelial carcinoma with divergent morphologies: glandular, rhabdoid and plasmacytoid variants
  4. Invasive urothelial carcinoma with divergent morpholgies: micropapillary and tubular variants
  5. Invasive urothelial carcinoma with divergent morpholgies: sarcomatoid and glandular variants
Invasive urothelial carcinoma with divergent morphologies: glandular, rhabdoid and plasmacytoid variants