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High-grade Papillary Urothelial CA (WHO/ISUP Classification, 2004) invading muscularis propria

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Comments:
One of the most challenging tasks faced by pathologist reading bladder biopsies/transurethral resections is the correct identification of muscularis propria invasion. It is critical to not confuse thin, delicate, discontinuous fascicles of muscularis mucosae for muscularis propria since patient with muscularis propria invasion may be offered cystectomy. Muscularis propria has thick fascicles as seen here.

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