PMC7401991_01
Computer tomography scan images of lower abdomen.
A. Axial CT with IMT (arrow and dotted) in the urinary bladder. B. Coronal CT with IMT (arrow and dotted) in the urinary bladder.
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The CT scan of abdomen showed large bladder mass occupying the posterior and right lateral wall of the urinary bladder (Fig. 1).
Inflammatory myofibroblastic tumor in the urinary bladder.
A. Low-power view. B. High power view showing spindle cells (arrows) with interspersed inflammatory cells (notched arrows).
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No bladder muscle component was identified in the specimen (Fig. 2).
Immunohistochemical stains for inflammatory myofibroblastic tumor in the urinary bladder. A and B. Tumor cells show positive reactivity for pankeratin and smooth muscle actin. C-E. Tumor cells show negative reactivity for desmin, p63 and ALK.
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The IHC studies were performed to reveal diffuse positive reactivity for pankeratin and focally for smooth muscle actin but no reactivity for desmin and p63 confirming the diagnosis for inflammatory myofibroblastic tumor (Fig. 3A-3D). The immunohistochemistry study for anaplastic lymphoma kinase (ALK) expression was negative (Fig. 3E).
FISH and immunohistochemistry studies for inflammatory myofibroblastic tumor in the urinary bladder.
A. The tumor cells failed to show 2p23 ALK gene rearrangement. The arrows indicate the intact juxtaposed green and red signals in the tumor cells. B. Tumor cells showed no reactivity (lack of brown staining cells) for uroplakin II.
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The tumor cell failed to demonstrate 2p23 gene rearrangement as well as any reactivity for uroplakin II (Fig. 4).