Urinary Bladder برای بزرگنمایی عکسها کلیک را روی ان نگه دارید Figure 25.1 Gross Appearance of Adenocarcinoma Arising From Urachal Remnants. A, The tumor protrudes as a polypoid ulcerated mass from the dome of the bladder. B, The cut surface shows a large intramural mass of mucinous appearance Figure 25.2 Gross Appearance of Endometriosis of Bladder. Multiple small red nodules protrude from the bladder surface Figure 25.3 Granulomas induced by BCG therapy for urothelial carcinoma Figure 25.4 High-power view of malakoplakia of bladder, showing numerous histiocytes with Michaelis-Gutmann bodies (arrows) Figure 25.5 A, Cystitis cystica has invaginated urothelial nests with a central lumen lined by urothelial cells, while (B) cystitis glandularis is characterized by luminally oriented eosinophilic cytoplasm. C, Some cases of cystitis glandularis have intracytoplasmic mucin (intestinal metaplasia) that is often admixed with otherwise typical von Brunn nests and cystitis cystica Figure 25.6 Rare cases of cystitis glandularis with intestinal metaplasia have abundant extravasated mucin that may cause a large mass lesion simulating malignancy Figure 25.7 Nephrogenic Adenoma. A complex clustering of gland-like formations lined by cuboidal to flattened cells is seen surrounded by an edematous stroma Figure 25.8 Papillary/polypoid cystitis is characterized by either broad bulbous projections or relatively broad-based simple excrescences, often with marked lamina propria edema Figure 25.9 Postradiation architectural and cytologic atypia of bladder epithelium. These changes are sometimes overinterpreted as carcinoma, but the admixture of epithelium and fibrin, and the associated vascular ectasia and congestion are characteristic of this benign process Figure 25.10 Exophytic and papillary pattern of growth of a urothelial carcinoma arising in a bladder with hypertrophy of the wall due to prostatic nodular hyperplasia. The tumor, which was located in the left lateral wall, was treated by total cystoprostatectomy. The prostate shows an incidental infarct Figure 25.11 Various Types of Noninvasive Papillary Urothelial Neoplasms of the Bladder. A, Papiloma. B, Papillary urothelial neoplasm of low malignant potential (PUNLMP). C, Low-grade papillary urothelial carcinoma. D, High-grade papillary urothelial carcinoma Figure 25.12 Inverted Papilloma of Bladder. A, The proliferation has a festoon-like quality and is located below a flat epithelium. B, High-power view showing the oval to spindle shape of the cells and their lack of atypia Figure 25.13 Urothelial Carcinoma in situ of Bladder. Note the nucleomegaly and irregular, clumpy chromatin (upper left) as compared to adjacent normal urothelium (lower right) Figure 25.14 Urothelial Carcinoma in situ of Bladder. The tumor has detached from the underlying stroma, only a few residual malignant cells remaining, resulting in the picture known as clinging or denuding carcinoma in situ Figure 25.15 Focal superficial lamina propria invasion by urothelial carcinoma of bladder, which is characterized by detached clusters of urothelium with cytoplasmic eosinophila, irregular contours, and sur- rounding stromal retraction. Figure 25.16 Muscularis propria invasion by urothelial carcinoma of bladder. Figure 25.17 Urothelial carcinoma with squamous differentiation Figure 25.18 Invasive micropapillary carcinoma of the bladder Figure 25.19 Plasmacytoid carcinoma of the bladder Figure 25.20 Nested Urothelial Carcinoma. A, Low-power magnification shows the irregular deep infiltration by the urothelial nests despite bland cytologic features (B) Figure 25.21 Lymphoepithelial-like carcinoma of the bladder Figure 25.22 Sarcomatoid carcinoma of bladder with heterologous differentiation Figure 25.23 Mucinous adenocarcinoma located in the dome of the bladder, probably arising from urachal remnants Figure 25.24 A, Primary mucinous adenocarcinoma of bladder may be histologically indistinguishable from secondary involvement by colorectal adenocarcinoma, but (B) some rare adenocarcinomas may not have a mucinous or enteric appearance Figure 25.25 Low-power (A) and high-power (B) views of clear cell adenocarcinoma of bladder. This rare tumor should be distinguished from the much more common nephrogenic adenoma Figure 25.26 Clear cell adenocarcinoma of bladder metastatic to regional lymph node Figure 25.27 Gross appearance of paraganglioma of bladder. The tumor is well circumscribed and yellow Figure 25.28 Microscopically, paragangliomas often show this subtle nested pattern, but sheet-like growth and stromal hyalinization may also occur Figure 25.29 Small Cell Neuroendocrine Carcinoma of Bladder. A, Low-power view showing a solid mass of small cell carcinoma covered by mucosa with carcinoma in situ. B, High-power view of the invasive small cell component Figure 25.30 Pure Squamous Cell Carcinoma of Bladder. The tumor is heavily keratinized Figure 25.31 Immunophenotype of myofibroblastic proliferations of the urinary bladder. Strong immu- noreactivity for keratin (A) and actin (B) Figure 25.32 Postoperative Spindle Cell Nodule. A, Low-power microscopic view showing well-developed fascicular arrangement of the proliferating cells. B, High-power view showing extreme cellularity and numerous mitotic figures Figure 25.33 A and B, Inflammatory myofibroblastic tumor. Highly cellular spindle cell proliferation showing a moderate degree of atypia and somewhat edematous stroma. There is an associated inflammatory mononuclear component Figure 25.34 Gross appearance of botryoid rhabdomyosarcoma of bladder. A huge tumor mass is seen filling the bladder lumen Figure 25.35 Microscopic Appearance of Botryoid Rhabdomyosarcoma. A, Low-power view showing polypoid mass protruding beneath a flattened epithelium. B, High-power view showing "cambium layer." Clusters of tumor cells present immediately beneath the epithelium result in a nevoid appearance
