Urothelial CA - Lymphoepithelioma-like

This variant of urothelial carcinoma resembles undifferentiated nasopharyngeal carcinoma. It consists of syncytial sheets of tumor cells and a prominent chronic inflammatory infiltrate in the stroma. The infiltrate is composed largely of lymphocytes (majority are T-cells), but may also have plasma cells, eosinophils, and other inflammatory cells which may create an appearance of chronic cystitis at first glance. However, scattered large atypical nuclei can be spotted even at this magnification. Besides chronic cystitis, lymphoepithelioma-like variant of urothelial carcinoma has to be distinguished from malignant lymphoma.