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Pseudocarcinomatous hyperplasia is an unusual response of the damaged urothelium seen in some cases of radiation cystitis. The proliferative changes consist of nests and cords of urothelial cells extending into lamina propria mimicking invasion. These nests may show nuclear atypia, prominent nucleoli, and mitotic figures adding to the confusion. Some cases show squamous metaplasia.

Image 31 of 36