摘要
目的 探讨原发性膀胱透明细胞癌的临床、病理、组织化学特征以及诊疗方法. 方法 原发性膀胱透明细胞癌患者1例,女,71岁.因尿频尿急4个月,下腹隐痛2个月入院.盆腔CT及膀胱镜检查示膀胱三角区近左侧直径约4.0 cm隆起性占位,基底宽,表面充血明显.病理活检示膀胱黏膜固有层小巢性透明细胞癌组织浸润,癌细胞排列呈大小不等腺管状、巢状分布,大部分细胞胞质丰富、透明.入院后出现反复无痛性肉眼血尿,并伴有下腹胀痛. 结果术中发现肿瘤位于膀胱左后侧壁,呈浸润性生长,膀胱组织与子宫前壁黏连明显,行膀胱部分切除、输尿管膀胱移植术联合全子宫双附件切除术.术后病理示：透明细胞癌组织浸润膀胱全层.子宫前壁内可见少量癌组织浸润,呈透明细胞癌图像.组织化学：PAS（＋）,免疫组化染色：CK7、CK5/6及EMA标记（＋）,CK20、Vimentin、Claretinin、PSA、CEA及NSE表达均为（-）.电镜下瘤细胞胞质多呈大空泡状,细胞器稀少,局部残留密集的糖原颗粒;部分瘤细胞胞质器以丛状聚集的糖原颗粒和小泡状结构为主.术后行全身化疗2次,随访6个月未见复发. 结论原发性膀胱透明细胞癌是一种少见的膀胱腺癌,确诊需依据临床表现、病理学检查及组织免疫学检查.治疗以手术为主,预后好于其他非尿路上皮癌.
Objective To investigate the clinical,pathological and histopatholo（g）ical features of primary bladder clear cell carcinoma and discuss the diagnosis and treatment of the disease. Methods The clinical and pathological features of one primary bladder clear cell carcinoma case retrospectively were analyzed,with the combination of reviewing reported literatures. Results The patient came to hospital with the chief complaint of urinary tract symptom and gradually developed gross hematuria.The tumor was located in the left wall of the bladder and was confirmed to be clear cell carcinoma by preoperative biopsy.Partial cysteetomy,ureteroneocystostomy and hysterectomy plus bilateral adnexectomy were performed.The patient received chemotherapy postoperatively and was tumor free 6 months post operatively. Conclusions Primary clear cell carcinoma of the bladder is a rare type of bladder adenocarcinoma.The diagnosis depends on the clinical and pathological study.Surgical operation is effective and the outcome of the disease is better than other non-urothelium carcinoma.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2010年第5期328-330,共3页
Chinese Journal of Urology
关键词
膀胱肿瘤
腺癌
透明细胞
Urinary bladder neoplasms
Adenocarcinoma,clear cell
