Here is his bone scan. Most of the darker areas represent me | Figure 1

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Here is his bone scan. Most of the darker areas represent metastatic lesions from prostate cancer.

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Here is a cystoprostatectomy (Bladder & Prostate) specimen removed for invasive bladder cancer. The prostate is at the bottom of the pic, shown with the green arrow. This tumor (black arrow) appears obviously necrotic, however the appearance is compounded by the presence of bladder stones. The stones can break down with the help of fluid (urine) and become somewhat of a coarse paste-like consistency. This substance is adherent to, and basically indistinguishable from, the tumor. It does, however, give us a pretty good idea of the size of the tumor itself. In addition to this obvious area, the surrounding mucosa looks concerning as well. Is this the ‘true’ border and size of the tumor or is this just reactive change? Does the area marked with a drawn arrow demonstrate tumor involving the left ureteral orifice? (Probes entering both ureters) Are the margins free of tumor? Is the prostate involved by tumor? These are the many questions we must answer and help the Pathologist answer as a Pathologists’ Assistant.

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