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case_images: MRI images of cT3N0M0 bladder cancer before TURBT: (a) sagittal view of the T2-WI image; (b) axial view of the T2-WI image; (c) axial view of the DWI image; (d) axial view of the contrast-enhanced image.
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case_images: Cystoscopy and MRI revealed a nodal tumor of VI-RADS score 2 in the left lateral wall (Fig. 1).
case_images: Microscopic examination of the TURBT specimen of the primary tumor showed pT2 and G3 urothelial carcinoma in hematoxylin and eosin staining (a) with PD-L1 expression in the majority of tumor cells (b). The dissected obturator LN showed an accumulation of foamy macrophages and fibrosis without viable tumor cells (c).
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case_images: TURBT revealed pT2 and G3 urothelial carcinoma with cis (Fig. 2a). TURBT remained in the primary tumor. The dissected obturator LN showed an accumulation of foamy macrophages and fibrosis without viable tumor cells (Fig. 2c), suggesting a good therapeutic effect. Immunohistochemical evaluation using anti- PD-L1 monoclonal antibody (clone 28-8) and the TURBT specimen showed PD-L1 expression in the majority (60%) of tumor cells (Fig. 2b).
case_images: Time-course of metastatic obturator LN (a) with prognostic factors associated with metastatic urothelial carcinoma (b, c). NLR and SII represent neutrophil/lymphocyte and PLT x neutrophil/lymphocyte, respectively. NLR and SII improved concurrently with the shrinkage of the metastatic LN (b).
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case_images: NLR and SII (NLR x PLT count [x103/muL]) were decreasing concurrently with shrinkage of the LNM (Fig. 3).