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.

Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue
Microscopic image possibly detecting cancerous areas in human tissue

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

CASE SUMMARY