Date of Presentation:8/18/2021

Attending pathologist: Anil Parwani, MD, PhD, MBA

Presented by: Nermeen Chaudhry

Prepared by: Tanner Hardy, DO



A 71 year old male with history of invasive bladder carcinoma and left ureteral urothelial carcinoma presented with hematuria. CT urogram and a TURBT showed invasive poorly differentiated urothelial carcinoma, high grade, with invasion into the muscularis propria of the left bladder wall.

After resection and radiation/chemotherapy, a worrisome lesion was seen on imaging and a cystoscopy was performed and revealed a sessile bladder lesion > 5cm at the site of the prior resection, along the left lateral bladder.


What is the most likely diagnosis?

  1. von Brunn’s nests
  2. Inverted papilloma
  3. Nested variant of urothelial carcinomas
  4. Nephrogenic metaplasia
Nested variant of urothelial carcinomas