We report the case of a 30-year-old woman who smoked 20 cigarettes per day and had no other relevant personal history.
The patient reported recurrent urinary tract infections.
Abdominal ultrasound showed a nodular intravesical lesion, which was referred for urology consultation.
Cystoscopy revealed an exophytic tumor measuring 3x3 cm in the right lateral face with intact bladder mucosa, with no changes found in the rest of the bladder.
Examination under anesthesia (EBA) and transurethral resection of the lesion (TUR) were performed.
Macroscopically, the pathology report describes fragments of the bladder wall with preserved urothelium without dysplasia, highlighting in the muscular layer and in continuity with the muscle tissue of the same, a vetocellular eosinophil tumor with large nuclei.
This cellularity is available in forms of ill-defined fascicles and between it is recognized abundant cellularity constituted fundamentally by numerous plasma cells and polymorphonuclear leukocytes eosinophils.
There is no high mitotic index, although proliferation index measured as nuclear positivity with antibodies against MIB-1 is between 10 and 25% of tumor cellularity.
No areas of necrosis were observed.
Immunohistochemical study showed marked positivity for cytokeratins (AE1/AE3) and CAM5.2 at cytoplasmic level, as well as marked cytoplasmic positivity with antibodies against p80 (ALK protein).
Described cellularity has antibodies against smooth muscle (soft muscle actin, MyO D1 and Calretinin), as well as CEA and high molecular weight cytoratins isolated and negative result only focal positivity
After FISH was performed on paraffin-embedded material, there was no evidence of translocation in the ALK gene.
The definitive pathological diagnosis is inflammatory myofibroblastic bladder tumor.
