摘要
目的探讨膀胱软斑症的影像学、病理学特征及治疗方法与预后,提高对该病的认识及诊治水平,避免误诊、漏诊。方法收集郑州大学第一附属医院2011年7月至2016年7月收治的膀胱软斑症5例,分析患者的临床特征、影像学及组织病理特点,并复习相关文献。结果5例膀胱软斑症患者CT检查显示:3例单发或者多发膀胱占位,1例膀胱炎样改变,1例膀胱内多发小结节影。膀胱镜检:4例患者膀胱内可见散在的类圆形结节,稍凸起于黏膜表面,局部黏膜呈乳黄色或者黄灰色改变;5例患者均采用外科手术电切+抗生素治疗,术后免疫组化显示组织细胞CD68弥漫性阳性,CK20部分阳性,Ki-67增值指数约10%;PAS、普鲁士蓝铁染色阳性率100%,六胺银染色阳性率80%,1例六胺银染色(-);随访3~12个月,3例无复发,1例术后4个月因结肠癌死亡,1例术后3个月复发。结论膀胱软斑症是一种罕见的肉芽肿性疾病,无特异性临床表现,其诊断主要依靠病理学,主要治疗方法有膀胱电切手术及抗生素。术后有复发可能,治疗效果有待进一步观察。
Objective To investigate the imaging,pathological features,treatment and prognosis of bladder soft spot,so as to improve the understanding of the disease and the level of diagnosis and treatment,and avoid misdiagnosis and missed diagnosis.Methods Five cases of bladder soft spot in the First Affiliated Hospital of Zhengzhou University from July 2011 to July 2016 were collected and diagnosed.The clinical features,imaging and histopathological features were analyzed,and the related literature was reviewed.Results The CT examination of 5 patients with vesical soft spot showed that 3 cases had single or multiple bladder mass,1 case had cystitis change,and 1 case had multiple small nodule shadow in the bladder.Cystoscopy of 4 cases with bladder malakoplakia showed scattered circular nodules in the bladder,slightly protruding on the mucosal surface and milky yellow or yellowish gray local mucosa.All of the 5 patients were treated with electrosurgery and antibiotics.Immunohistochemical staining showed diffusely positive CD68 and partial positive CK20 in histiocytic cells.The Ki-67 value added index was about 10%.The positive rate of PAS and Prussian Blue Iron stain was 100%,while the positive rate of Gomori Methenamine Silver(GMS)was 80%,and GMS was negative in 1 case.Follow up for 3-12 months,3 cases had no recurrence,1 case died of colon cancer in 4 months after operation,1 case recurred in 3 months after operation.Conclusions Malakoplakia is a rare inflammatory condition without specific symptoms.Its clinical diagnosis mainly depends on pathological diagnosis.The main treatment methods are bladder electric resection and antibiotics.There is a possibility of recurrence after operation,and the therapeutic effect needs to be further observed.
作者
海彬
秦进
刘会范
Hai Bin;Qin Jin;Liu Huifan(Gastrointestinal Endoscopy Center,the First filiated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国实用医刊》
2019年第2期1-3,共3页
Chinese Journal of Practical Medicine
关键词
膀胱软斑症
M-G小体
免疫组化
特殊染色治疗
Malakoplakia of bladder
Michaelis-Gutmann bodies
Immunohistochemistry
Special staining therapy
