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  • Diagnosed and treated for urinary tract infection, and struvite cystalluria 6 weeks ago
  • Presented for a recheck of urinary tract infection
  • Has been doing well at home. Only dribbling when excited
  • A round to ovoid shaped, mixed, echogenicity and gravity dependent structure with slightly irregular margins within the lumen of the urinary bladder
  • A few pinpoint hyperechoic foci are seen within the structure
  • No distal shadowing artifact is noted.
  • The structure is in contact with the mucosa surface of the dorsal urinary bladder wall.
  • Few irregular defects on the structure.
  • Well defined curved margins of the structure towards the contact with the dorsal wall of the urinary bladder. This is indicative of an intramural structure
  • The remainder of the urinary bladder mucosal surface is smooth and without thickening
  • Organized blood clots
  • Atypical urocystoliths
  • Neoplasia and polyps
  • Cystoscopy
  • Follow up ultrasound
    • Color flow Doppler to assess for vascularity
    • Ballottement to see if the mass is adhered to the wall
    • Standing ultrasound
    • FNA, depending on additional findings

This structure was a pus ball that consisted of lysed red blood cells admixed with fibrin, unidentified amorphous material and aggregates of atypical squamous epithelial cells with variable size nucleus and nucleolus.

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