摘要
目的探讨膀胱微囊型尿路上皮癌(MUC)的临床病理特征、诊断与鉴别诊断。方法对1例MUC进行光镜和免疫组化染色观察,并复习相关文献。结果患者女性,56岁。肉眼血尿伴尿痛40天。镜检:瘤细胞呈巢团状排列,巢状结构中央可见多量大小不等、圆形或卵圆形的囊腔,腔内空虚,囊壁被覆多层或单层尿路上皮,个别囊衬覆单层扁平细胞,中等大小,形态一致,核圆形,核仁不明显,核分裂象少见。瘤细胞弥漫浸润性生长,侵及膀胱浆膜层,并呈盆腔淋巴结、左卵巢及左输卵管广泛转移。免疫组化:CKpan、CK7、34βE12、p 63和CEA均弥漫强(+),p 53散在(+),而vimentin、CK20、mucin 5AC、PSA、CgA和Syn均(-),Ki-67阳性指数为30%。患者术后6个月死于全身骨转移。结论 MUC是一种罕见且具有高度侵袭性、预后不良的尿路上皮癌亚型,由于瘤细胞形态温和,病理诊断时需与膀胱的腺(囊)性膀胱炎、肾源性腺瘤等良性病变以及原发性腺癌等病变鉴别。
Objective To study the clinicopathological features, diagnosis and differential diagnoses of microcystic urothelial carcinoma （MUC） of the urinary bladder. Methods A case of MUC of the urinary bladder was observed by light microscopy and immunohistochemistry, and relevant literatures were reviewed. Results The tumor occurred in a 56-year-old women who presented with macroscopic hematuria for 40 days. Tumor cells were arranged in nests, which were composed of round, oval and variable sized cysts lined by single to several layers of urothelial, flattened, or cuboidal cells. The cysts might be empty or contained mucin secretion. The tumor extensively infiltrated the muscularis propria.Immunohistochemically, tumor cells were diffusely positive for CKpan, CK7, p 63, 34βE12 and CEA , but negative for vimentin, CK20, mucin 5AC, PSA, CD56, CgA and Syn. Percentage of positively stained cells for Ki-67 was 30%. Conclusions MUC is a rare and highly aggressive tumor, and a variant of urothelial carcinoma with poor prognosis. The tumor should be differentiated from adenocarcinoma and, more importantly, from benign lesions, such as cystitis glandularis or cystitis cystica.
出处
《诊断病理学杂志》
CSCD
北大核心
2013年第11期682-684,689,共4页
Chinese Journal of Diagnostic Pathology
关键词
膀胱肿瘤
尿路上皮癌
免疫组化
Bladder neoplasms
Urothelial cell carcinoma
Immunohistochemistry
