A 67-year-old woman presented with multiple episodes of gross hematuria. Urine cytology was consistent with malignancy and follow-up CT urogram demonstrated polypoid and sessile lesions in the bladder dome. The patient underwent cystectomy. Microscopy is shown below for two adjacent areas of tumor (area one—image 1, area two—images 2 & 3). Area two demonstrated diffuse positivity for synaptophysin and chromogranin.
Matthew Woge, M.D.
Resident, Anatomic/Clinical Pathology
Carrie Inwards, M.D.
Consultant, Anatomic Pathology
Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine