PMC5820658_01
Endoscopic appearance of the tumor. Resectoscope reveals the tumor just before biopsy by forceps on TURBT.
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Cystoscopy revealed nonpapillary bladder tumor on the right wall.  Figure 1 shows the tumor before resection during TURBT.
Pelvic MRI. Pelvic MRI T2 showed a 2.5 cm relatively homogenous mass (allow) in the right lateral bladder wall without extending base of the bladder wall.
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Pelvic MRI T2 showed a 2.5 cm relatively homogenous mass in the right lateral bladder wall without extending the base of the bladder wall (Figure 2).
Histopathology of the tumor. (a) Hematoxylin-eosin stain. The epithelial part of the tumor consists of high-grade urothelial carcinoma and the mesenchymal part is composed of oval to spindle shaped cells proliferation. (b) Immunohistochemical staining indicates CK-7 positive. (c) Immunohistochemical staining shows  alpha-smooth muscle actin positive. (d) Immunohistochemical staining reveals vimentin positive.
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The epithelial part of the tumor consisted of high-grade urothelial carcinoma and the mesenchymal part composed of oval to spindle shaped cells proliferation (Figure 3(a)). Immunohistochemically, the malignant carcinomatous cells stained positive for cytokeratin 7 (CK-7) (Figure 3(b)). In contrast, the mesenchymal components stained positive for vimentin (Figure 3(c)) and  alpha-smooth muscle actin (alpha-SMA) (Figure 3(d)), but the other mesenchymal markers were negative. 