Date of Presentation:8/18/2021

Attending pathologist: Anil Parwani, MD, PhD, MBA

Presented by: Nermeen Chaudhry

Prepared by: Tanner Hardy, DO

Organ:Bladder

HISTORY:

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.

GROSS:

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