Histopathological analysis of a bladder cancer stalk observed on MRI

Papillary transitional cell carcinoma of the bladder has a loose connective tissue stalk. For staging of bladder cancer on magnetic resonance imaging (MRI), it is important to clearly separate the cancer from the bladder wall . It is possible to distinguish a stalk from the cancer by the difference o f intensity on the using MRI. Sixteen stalks of 20 polypoid bladder tumors on any of the T2W1, dynamic images and delayed enhanced images were demonst rated. Most of the stalks show lower signal intensity than the tumors on T2 W1, less enhancement on dynamic images and stronger enhancement on delayed enhanced images. The stalk consisted of fibrous connective tissue, capillar y blood vessels, inflammatory cell infiltration and edema. This stalk exten ded from the bladder wall to the center of the tumor. Some of the superfici al muscular bundles were pulled into the stalk. These histopathological fin dings were compatible with the patterns of signal intensities on MRI. The i dentification of the stalk of a polypoid tumor may be an important observat ion to exclude bladder wall invasion by tumor. (C) 2000 Elsevier Science In c. All rights reserved.