Inverted papilloma is a rare benign urothelial neoplasm seen usually in older men. In its classic appearance, it is an endophytic lesion consisting of cords and trabeculae of urothelial cells growing into the lamina propria. The overlying urothelium is usually smooth. Due to the endophytic growth pattern, the arrangement of urothelial cells is reversed. The nests and cords show peripheral palisading of basal cells (darker cells in this image) and mature cells in the center. Occasionally, there may be non-keratinizing squamous or even glandular epithelium within the center of the nests.