2020-19 / May 11 (Contributor: Stephanie J Conrad and Ming Zhou)
A 53 year old male with pT3b prostate cancer developed gross hematuria 20 months after receiving external beam radiation. A cystoscopy showed friable mucosa, which was thought to be suspicious for bladder cancer.
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1. What is the correct diagnosis?
a. Nested Variant Urothelial Carcinoma (NVUC)
b. Florid von Brunn Nests
c. Inverted Papilloma
d. Inverted Urothelial Carcinoma
e. Pseudocarcinomatous Epithelial Hyperplasia
2. What immunohistochemical marker with diffuse staining is most useful to support the diagnosis?
b. CK 20
e. HMW keratin
3. What histological feature supports the diagnosis?
a. Hyperplastic inverted urothelial nests
b. Rare mitoses
c. Irregular urothelial nests associated with infiltrating single cells
d. Urothelial nests encircling vessels with fibrin deposits
e. Invasion of the detrusor muscle