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Answer: C, Neoplasm.
Given the finding of a focal area of wall thickening on the prior CT, this mass is most likely a neoplasm arising in the wall of the diverticulum. MR shows a solid mass that is hypointense on both T1 and T2 sequences with regions of enhancement following Gadolinium administration.
Cystoscopy showed a large bladder mass emanating from the right bladder diverticulum with clot superficially and deeper friable tissue which bled easily with manipulation.
Pathology showed an undifferentiated malignant epithelioid neoplasm with extensive necrosis and detached overlying strips of reactive urothelium and squamous epithelium. No muscularis propria was identified.
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