2.  A middle-aged woman presents with a 3-month history of suprapubic discomfort, dysuria, and frequency. Urine cultures are negative. The finding of mucosal fissures on cystoscopy and mucosal/submucosal chronic inflammation with mast cells on biopsy is most consistent with:

  3.  A 68-year-old woman undergoes excision of an easily bleeding polypoid mass protruding through the urethral meatus. Histologically, it is composed of vascular tissue with chronic inflammatory cells and islands of squamous epithelium. The most likely diagnosis is:

  4.  A plaque of the urinary bladder mucosa is biopsied. The biopsy shows a mixed inflammatory infiltrate predominantly located within the lamina propria, consisting of nodules of histiocytes surrounded by lymphoid aggregates. As shown by this picture, there are round laminated inclusions. Which of the following mechanisms is related to this lesion?

  5.  Which of the following is the most important predisposing condition for the development of bladder cancer in the United States?

  6.  Pathologic staging of urothelial carcinoma (UC) of the bladder shows the poorest interobserver reliability in evaluating the depth of invasion into the:

  7.  Biopsies of a 2.0-cm exophytic tumor in the bladder trigone of a 57-year-old man show papillary structures lined by more than 10 layers of epithelial cells. Nuclear atypia is moderate, mitoses are rare, and there are foci of necrosis. The neoplasm infiltrates the underlying muscularis propria. Which of the following is the most important parameter influencing the prognosis?

  8.  A 60-year-old woman without prior history of cancer presents with newly onset right hemiparesis. An MRI shows a ring-enhancing mass in the left frontal lobe. A biopsy reveals a carcinoma immunoreactive for CK7, CK20, and GATA3. Which of the following is the most likely source of this metastasis?

  9.  This photomicrograph depicts a papillary urothelial lesion. Which one is it?

10.  The degree of cytologic and architectural atypia present in the urothelial lesion in this picture is most compatible with:

11.  A papillary tumor of the bladder exhibits the cytologic and architectural features shown in this picture. This urothelial lesion is:

12.  A 66-year-old man presents with dysuria, urgency, and microscopic hematuria. Following cytologic studies and cystoscopy, biopsies reveal the presence of the lesion shown in this picture. Which of the following is true about this lesion?

13.  Of the following types of urothelial carcinoma (UC) with divergent differentiation, which one is the most common?