PMC6344176_01
CT-scan showed a low-density mass near the bladder neck and a large number of blood clots in the bladder.
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F1
A computed tomography (CT) scan of the abdomen and pelvis showed a mass near the bladder neck and massive blood clots in the bladder (Fig. 1).
Angiographic results before (a) and after vascular embolization (b).
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F2
Aiming to wait for hematuria to be controlled and then re-cystoscopy before we can perform the treatment, we consulted the interventional department for bladder tumor vascular embolization (Surgery related images shown in Fig. 2) in the hope of controlling bleeding.
Changes in hemoglobin since admission to hospital.
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F3
To elaborate the change of hemoglobin in patient more intuitively, we specially created a line chart (Fig. 3).
Histological examination (hematoxylin-eosin staining; magnification 10 x 40) shows spindle cell proliferation with a fascicular pattern admixed with inflammatory cells on a myxoid background. And the immunohistochemistry examination results: positive SMA staining (SMA stain, x 400); positive ALK staining (ALK stain, x 400); negative CK staining (CK stain, x 400); Ki-67 staining, with Ki-67 index about 20%. CK = cytokeratin, SMA = smooth muscle actin.
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F4
Postoperative pathological results show that it is bladder myofibroblastic tumor with muscle layer infiltration, finding tumors in the basement (Fig. 4).