来源：华夏病理泌尿微信群

男，62岁，膀胱癌行膀胱灌注化疗治疗后

 陈国群：镜下以梭形细胞为主，异型明显，这是膀胱癌复发吗？这是治疗后细胞变异的结果嘛？

孔祥田：@陈国群 your ddx includes sarcomatoid urothelial ca vs inflammatory myofibroblastic tumor. Tell me which one you choose? 

陈国群：我倾向术后梭形细胞结节。 

厚道：已有明显的浸润癌了！ 

陈国群：这是刚开始的考虑，但细胞异型这么大，病理性核分裂很多，所以又想是不是肉瘤样癌。

孔祥田：No. Too much atypia! I favor sarcomatoid ca@陈国群 。 

陈国群：我做了一些标记，cd68强阳性，p63阴性，ck7部分阳，ck20阴性，怎么解释呢 

孔祥田：Prolifrative cystitis ，@陈国群 so far the IHCs support high grade sarcomatoid urothelial ca. Wait for your further IHC work up. By the way, chemotherapy won't change the cancer morphology! I don't know where you got the concept?