膀胱炎性假瘤的临床特征(附2例报告并文献复习)

目的:探讨膀胱炎性假瘤的临床特征。方法:报告2例膀胱炎性假瘤患者的临床资料,并复习有关文献。2例术前均误诊为膀胱恶性肿瘤而行膀胱部分切除术,术后病理检查证实为炎性假瘤。结果:术后随访至今无复发和转移。结论:膀胱炎性假瘤是一种发生在膀胱间质的瘤样病变,临床很少见,易误诊为恶性肿瘤;避免误诊和不必要的扩大手术及术后放、化疗十分重要。     

膀胱炎性假瘤2例报告

膀胱炎性假瘤临床少见，近3年来我院收治2例，均经病理证实。现报告如下。     

假瘤性腺性囊性膀胱炎的临床诊断与治疗

正假瘤性腺性囊性膀胱炎临床上较少见,常见临床表现为尿频、尿急、尿痛、血尿、排尿困难、下腹部疼痛等~([1])。现对9例患者的临床资料进行回顾性分析。对象与方法一、对象我院2006年3月~2015年6月收治9例假瘤性腺性囊性膀胱炎患者,男4例,女5例,年龄26~63岁,平均年龄43岁,病程0~10年,平均病程3.4年,主要临床表现为血尿、排尿困     

假肌源性血管内皮瘤一例分析并文献回顾

目的 探讨假肌源性血管内皮瘤的临床及影像学表现。方法 分析我院一例假肌源性血管内皮瘤的临床表现、实验室检查、影像学及病理学特征，并结合文献进行回顾，总结该病的临床、病理及影像学特征。结果 患者进行实验室及影像学检查后，行右侧髂骨肿物及右臀部皮下肿物切除术，术后恢复良好。结论 假肌源性血管内皮瘤是一种少见的低~中度恶性的血管内皮瘤，影像学上具有软组织肿瘤的特点，熟悉其临床表现、影像学及病理学特征，有助于对该病的诊断及鉴别诊断。     

腹膜假黏液瘤的研究进展

腹膜假黏液瘤是临床上较为少见的一类疾病,主要特征为黏液外分泌性细胞在腹膜或网膜种植而导致大量胶冻黏稠样腹腔积液。临床上无明显特异性表现,误诊率较高。通过提高对腹膜假黏液瘤的认识、完善相关检查和合理的标本取材进行病理检查可以提高腹膜假黏液瘤的诊断率。采用肿瘤细胞减灭术或大部肿瘤切除手术的手术方法联合腹腔热灌注化疗,有助于提高患者的生存期。     

囊液CA15-3蛋白含量测定鉴别胰腺粘液性瘤的良恶性

胰腺囊性病变主要有炎性假性囊肿、浆液囊性瘤、粘液囊性瘤和粘液囊腺癌。囊性假瘤和浆液囊腺瘤是良性的，粘液囊腺癌是恶性的，粘液囊性瘤虽是良性，但可癌变。假性囊肿在治疗上可采用引流术，而粘液肿瘤则要切除。由于治疗上的差异，术前确诊胰腺囊性病变的性质就显得非常重要。然而临床资料和影像学等检查常常不能确定胰腺囊性病变的良恶性。     

肾脏炎性假瘤5例诊治体会

目的提高对肾脏炎性假瘤的认识和诊治水平。方法报告5例肾脏炎性假瘤的诊治情况，结合文献就其诊治问题进行讨论。结果肾脏炎性假瘤的主要临床表现为腰痛、发热和患肾区叩击痛，影像学检查无特异性。5例患者中有2例用诊断性抗感染治疗治愈；有2例患者在B超引导下行穿刺活检确诊为炎症，予抗感染治疗治愈；另1例经探查及冰冻活检确诊为炎性假瘤，行肾部分切除术治愈。随访2～10年，未见复发。结论肾脏炎性假瘤的诊断应以临床表现为主，结合动态影像学检查，特别是抗生素治疗前后的对比。抗感染治疗有效。B超引导下穿刺活检是确诊的主要方法。术中冰冻活检可避免不必要的肾切除术。     

肺炎性假瘤的诊断与治疗

目的 探讨肺炎性假瘤的临床和影像学特点，降低误诊率，提高疗效。方法 对69例肺炎性假瘤患者的l脑床资料进行回顾性分析，所有患者均行手术治疗。结果误诊为肺癌29例(42．0％)，肺结核球或其它肺良性肿瘤13例，确诊为肺炎性假瘤27例(39．1％)。术后无并发症发生和死亡患者。结论 肺炎性假瘤属良性病变，其临床表现和影像学检查缺乏特征，易误诊为肺癌和肺部其它疾病，应提高对本病的认识，降低误诊率。术前肿块穿刺活检和术中冰冻病理切片是诊断和决定术式的主要依据。手术方式以局限性肺切除或肺叶切除术为主，原则上应最大限序她俣留币常肺组织．术后行病理检查，并随访。     

膀胱前间隙炎性假瘤诊治分析(附四例报告)

目的　探讨炎性假瘤的临床特点及膀胱前间隙炎性假瘤的病因、临床特点和误诊情况。　方法　回顾 4例膀胱前间隙炎性假瘤的诊治经过 ,结合文献分析其临床特点。　结果　 4例膀胱前间隙炎性假瘤均累及膀胱前壁 ,其中术前误诊为膀胱肿瘤 2例 ,4例均成功地行肿块连同部分膀胱壁切除手术 ,随访 3个月～ 6年无复发。　结论　既往输卵管结扎术和感染是膀胱前间隙炎性假瘤的重要致病因素 ,结合病史、临床表现和特殊检查仔细分析可以避免误诊 ,手术切除效果佳 ,预后良好。     

膀胱炎性肌纤维母细胞瘤合并腺性膀胱炎1例报告

本文回顾性分析1例膀胱炎性肌纤维母细胞瘤合并腺性膀胱炎患者的临床资料。患者因肉眼血尿, 偶伴尿痛20余天入院。术前影像检查提示膀胱前壁占位性病变, 大小约7.7 cm×6.1 cm×4.4 cm, 考虑膀胱癌可能性大。行机器人辅助腹腔镜膀胱部分切除术, 术后病理诊断为膀胱炎性肌纤维母细胞瘤合并腺性膀胱炎。膀胱炎性肌纤维母细胞瘤是一种起源于膀胱间叶组织的真性肿瘤, 属于临床罕见病, 合并有腺性膀胱炎目前尚未见报道。由于本病的临床表现和影像学检查表现与膀胱恶性肿瘤难以鉴别, 易造成误诊, 确诊主要依靠病理检查和免疫组化染色检查。治疗方法为经尿道膀胱肿瘤切除术、膀胱部分切除术或根治性膀胱切除术。     

Inflammatory pseudotumor of the prostate: a case report

We report a rare case of inflammatory pseudotumor of the prostate. A 42-year-old man with a history of hematospermia and chronic prostatitis presented with difficulty in voiding. Cystoscopy demonstrated a large non-papillary tumor occupying the prostatic urethra along with two bladder stones. Magnetic resonance imaging (MRI) demonstrated a 7-cm prostatic mass protruding toward the bladder and the rectum. Transrectal biopsy of the prostate demonstrated a fibrous lesion containing inflammatory cells without evidence of malignancy. We performed transurethral resection of the prostatic lesion to release the bladder outlet obstruction, followed by cystolithotripsy. Histopathological examination of the surgical specimen demonstrated a benign fibromuscular lesion with spindle cell proliferation, leading to a diagnosis of inflammatory pseudotumor. Postoperatively, the patient voided normally without any signs of recurrence on follow-up at five months. Inflammatory pseudotumor is an unusual benign lesion of unknown etiology. Only 10 previous cases of the disease involving the prostate have been reported in English and Japanese literature. Prostatic involvement of inflammatory pseudotumor may show a presentation similar to malignant prostatic sarcoma. Thus, accurate identification of this benign process is important in order to avoid unnecessary radical surgery.     

Spindle cell tumors associated with mycobacteria in lymph nodes of HIV-positive patients: 'Kaposi sarcoma with mycobacteria' and 'mycobacterial pseudotumor'.

Patients infected with HIV often have unusual manifestations of common infections and neoplasms. One such example is "mycobacterial pseudotumor," an exuberant spindle cell lesion induced in lymph nodes by mycobacteria. Kaposi sarcoma also produces a spindle cell proliferation in lymph nodes of HIV-positive patients. These two entities must be differentiated from one another because of differences in treatment and prognosis. We report here, however, three cases of intranodal Kaposi sarcoma with simultaneous mycobacterial infection, the occurrence of which has not been clearly documented. For comparison, we also studied three cases of mycobacterial pseudotumor, of which 14 cases have been described to date. There was considerable histologic overlap between these two lesions. Acid-fast bacilli were present in all cases, predominantly in the more epithelioid histiocytes in the cases of Kaposi sarcoma, and in spindle and epithelioid cells in the cases of mycobacterial pseudotumor. The morphologic features that favored Kaposi sarcoma over mycobacterial pseudotumor were the prominent fascicular arrangement of spindle cells and slitlike spaces, the lack of granular, acidophilic cytoplasm, and the presence of mitoses. Immunohistochemistry was a reliable adjunct study in the differential diagnosis, as the spindle cells in mycobacterial pseudotumor were positive for S-100 protein and CD68 whereas those of Kaposi sarcoma were CD31- and CD34-positive but negative for S-100 protein and CD68. Awareness that Kaposi sarcoma may coexist with mycobacterial infection in the same biopsy specimen is important because these lesions may be misdiagnosed as mycobacterial pseudotumor. The clinical impact of distinguishing between Kaposi sarcoma with mycobacteria and mycobacterial pseudotumor is significant because the presence of Kaposi sarcoma alters treatment and prognosis.     

Calcifying fibrous pseudotumor of the pleura

Calcifying fibrous pseudotumor is an uncommon benign lesion that has unique histologic features. We report a case of calcifying fibrous pseudotumor of the pleura occurring in a 31-year-old woman. A computed tomographic scan revealed a pleural mass in the right anterior costophrenic angle. The excised mass was well circumscribed, nonencapsulated, solid, and firm. The tumor showed dense hyalinized collagenous tissue interspersed with spindle cells, psammomatous calcifications, and a predominantly lymphoplasmocytic infiltrate. Most spindle cells were diffusely positive for vimentin, focally positive for CD34, and negative for desmins, smooth muscle actin, S-100 protein, and anaplastic lymphoma kinase-1.     

Inflammatory pseudotumor of carotid artery: a case report.

Inflammatory pseudotumor is an uncommon round and spindle cell proliferative lesion of unknown etiology that occurs most commonly in the lung. But it also occurs in diverse extrapulmonary locations such as the abdomen, retroperitoneum, pelvis, heart, head and neck, upper respiratory tract, trunk, bladder and extremities. The extrapulmonary inflammatory pseudotumor is often larger, less well circumscribed and multinodular. Proximity of the tumor to vital structures or involvement of vital organs compromises the opportunity for complete resection, thus higher recurrence rates are often reported even after surgical treatment. The authors report a case of inflammatory pseudotumor originating from the common carotid artery in a 42-year-old female patient with a rapidly growing neck mass, treated by en-bloc resection of inflammatory pseudotumor and a long segment of common carotid artery followed by PTFE graft interposition.     

Sclerosing inflammatory pseudotumor of the urinary bladder in a child.

A case of inflammatory pseudotumor of the urinary bladder in a 2-year-old child is presented. It was characterized by nodular intravesical growth and massive infiltration of the bladder wall. Microscopically, the lesion showed in its largest part a relatively paucicellular spindle cell growth and a sclerotic appearance with a thin superficial cellular zone resembling granulation tissue. Another morphological characteristic was a marked capillary proliferation revealed by immunohistochemical reactions to factor VIII-associated protein, laminin, and collagen IV. The last feature appears to be an integral part of the process, which most closely resembled fibromatosis of the adult type, a rare pattern of growth in inflammatory pseudotumor.     

Mycobacterial spindle cell pseudotumor of lymph nodes.

Two cases of spindle cell pseudotumor in the lymph nodes of patients with acquired immunodeficiency syndrome caused by mycobacterial infection are reported and the literature reviewed. The lesions mimicked neoplasms because they were composed predominantly of spindle cells arranged in a storiform pattern. Most of the spindle cells were phagocytic cells that contained large amounts of mycobacteria. It is important for the pathologist to recognize the lesion so that a prompt tissue diagnosis can be provided because specific therapy is available.     

Inflammatory pseudotumor of the bladder: a new case report

Inflammatory pseudotumor is a reactive benign lesion which can be very difficult to distinguish from some malignant bladder tumors like sarcomas or sarcomatoid carcinoma. Inflammatory pseudotumour (IPT) of the urinary bladder is a benign proliferate lesion which can simulate clinically and histologically a sarcoma. A case of an inflammatory pseudotumor of the urinary bladder in a 18-years-old man is presented. This patient presented with sudden onset of gross painless hematurial related to large polypoid and ulcerated bladder masses found on endoscopy. Initial pathological analysis was interpreted as rhabdomyosarcoma but subsequent reviews were consistent with a benign process resembling nodular fasciitis. This rare, benign and presumed non-neoplastic, reactive lesion must be differentiated from sarcomas of the urinary bladder. Immunohistochemistry seems to be the method of election in differentiating inflammatory pseudo-tumor from other spindle cell proliferations of the bladder. When diagnosis is certain, complete transurethral resection is the treatment of choice. However, if there is no total pathologic confirmation, if it is a very wide lesion or if it is recurring after endoscopic resection, a partial cystectomy is suggested.     

Clinical versatility of the inflammatory pseudotumor in urology

ObjectiveThe inflammatory pseudotumor is a rare lesion, having benign behavior and some histological heterogeneity that appears in the genitourinary tract. A series of urogenital inflammatory pseudotumors are reviewed with emphasis on their clinicopathological and immunohistochemical characteristics.Material and methodsA retrospective study the causistics treated between January 1981 in December 2010 was performed. It identified the cases of inflammatory pseudotumor with urogenital localization. The variables age, gender, symptoms, topography, treatment and anatomopathological and immunohistochemical characteristics of each case were analyzed.ResultsA total of 8 cases of the urogenital-located inflammatory pseudotumor are described. Of these, 6 were located in the bladder, one in the kidney and one in the epididymis. Mean age of the patients was 46.75 (±19.84) years. Tumor presentation symptoms were macroscopic hematuria, single symptom or accompanied by symptoms of the lower urinary tract and inguinoscrotal mass. In regards to treatment in the cases of bladder localization, transuretheral ± cystectomy were performed. In the case of kidney localization, treatment was made by means of pyelotomy and exeresis, and in the case of epididymis localization, simple exeresis was performed. The anatomopathological study showed inflammatory pseudotumor in every cases, having a mesenchymal and myxoid appearance, with fusiform cells of eosinophil cytoplasm, with presence of frequent inflammatory cells. The most common immunohistochemical pattern shows positivity for the muscle-specific actin (HHF-35), vimentin and negativity for protein S-100. ALK-1 was positive and 87.5% of the cases.ConclusionThe inflammatory pseudotumor is a condition having good prognosis which, when there is a good histopathological and immunohistochemical diagnosis, every urologist should recognize and distinguish in order to carry out as conservative a surgical treatment as possible.     

Inflammatory myofibroblastic tumor of the rectum in a 13-month-old girl: a case report

Inflammatory myofibroblastic tumor is a rare benign neoplasm. It is common in children and has been reported in various locations throughout the body but rarely in the rectum. A 13-month-old girl presented with a short history of a painless anal mass and no hematochezia. The mass was completely excised, and histologic examination of the initial biopsy showed fascicles of spindle cells in a mixed inflammatory background with predominance of plasma cells, typical of an inflammatory pseudotumor. The spindle cells were positive for smooth muscle actin and anaplastic lymphoma kinase staining. There is no evidence of recurrence or metastasis after a follow-up of 4.5 years.