Of clinical significance, heterogeneous histomorphology was a marker for immune heterogeneity within the tumor microenvironment and differential PD-L1 expression on tumor cells, and patients whose bladder tumors had marked intratumoral morphologic heterogeneity were less likely to benefit from treatment with the anti-PD-L1 inhibitor atezolizumab. The gene discussed is CD274; the disease is urinary bladder neoplasm.