原发性膀胱透明细胞癌1例

患者女性 ,6 1岁 ,无痛性肉眼血尿 1周 ,经抗炎治疗无效 ,来我院就诊。膀胱Ｂ超检查 :膀胱右侧壁见 - 1ｃｍ× 3ｃｍ低回声团块与膀胱壁相连 ,基底宽。膀胱镜检查 :膀胱右侧壁见一乳头状新生物 ,直径约 3ｃｍ ,其周围见 3个直径约0 5ｃｍ大的肿物 ,色淡。ＩＶＵ示双肾及输尿管显影正常 ,膀胱右下侧壁充盈缺损。入院后 ,行膀胱探查术。术中见肿物未侵出膀胱壁 ,将 4个肿物行电刀切除 ,术后肿物送病理检查。术中探查腹腔、盆腔其他脏器未见异常发现。术后抗炎对症治疗、免疫治疗、化疗一个疗程。术后 9个月患者出现尿频、尿急、排尿困难 ,再…     

横结肠憩室乳头状腺癌1例

患者女 ,6 6岁。右上腹痛 2月余。查体 :右上腹有 10ｃｍ长线形瘢痕 ,轻度压痛。Ｂ超示 :右上腹囊实性占位 ,11ｃｍ× 9ｃｍ× 9ｃｍ ,边界清晰 ,有完整壁回声 ,并有乳头状低强回声突入腔内。术中见囊性包块位于结肠肝曲上方 ,包块下极为结肠肝曲部肠管壁 ,无法分离 ,故行包块加相连的结肠段切除。既往史 :2年前曾做胆囊切除。病理检查　眼观 :囊性包块连同一段结肠标本一件 ,囊性包块 9ｃｍ× 8ｃｍ× 8ｃｍ ,结肠长 8ｃｍ ,直径 5ｃｍ ,肠腔面光滑 ,挤压囊肿壁 ,见污秽液体经肠壁一直径 0 2ｃｍ小孔流入肠腔。囊壁厚 0 3～ 0 6ｃｍ ,腔…     

膀胱憩室内肿瘤一例

患者,男,51岁。反复无痛性肉眼血尿3月,既往无类似发作。体检:一般情况佳,前列腺无增大。B超:双肾、膀胱未见异常。KUB IVP,双肾、输尿管未见异常,但位于膀胱左侧壁可见一约5cm×6cm憩室影。膀胱镜检查:左侧尿管开口不清,左侧膀胱壁可见一约2cm×2cm憩室口,内见少许絮状物,右侧输尿管开口清晰。于1997年7月     

膀胱具有横纹肌样形态的癌1例报道及文献复习

目的 探讨膀胱具有横纹肌样形态的癌的临床病理特征、诊断、鉴别诊断,以提高对本瘤的认识.方法 应用光镜、特殊染色和免疫组化染色对1例罕见的膀胱具有横纹肌样形态的癌进行观察,并复习相关文献.结果 瘤细胞松散,黏附性差,单个散在或弥漫片状排列,侵犯膀胱肌层.瘤细胞体积较大,圆形或多边形,胞质丰富,嗜酸性,核圆或卵圆形,居中或偏位,核内染色质细,核仁多不明显,核分裂象可见,散在单核或多核瘤巨细胞.免疫组化:瘤细胞呈CK-pan、EMA、CK18及CEA弥漫强阳性,CK20及34BE12散在阳性;而vimentin、SMA、desmin、myoD1、myoglobin、CK7、p63、CD38、S-100、HMB45、melan A、CgA、Syn、CD45、CD30、ALK和CD34均阴性.结论 膀胱具有横纹肌样形态的癌极罕见,可能为尿路上皮癌的组织学变异.诊断时须与其他具有横纹肌样细胞形态的肿瘤鉴别.     

前列腺增生症并巨大膀胱憩室手术疗效

目的探讨同时切除膀胱憩室、前列腺增生症的手术效果. 方法对前列腺增生症伴发巨大膀胱憩室40例,均行耻骨上经膀胱憩室及前列腺摘除术,术后留置气囊导尿管及膀胱造瘘管,持续冲洗膀胱至尿液转清. 结果术后出血致膀胱内血块堵塞需再次手术者2例;术后伤口感染3例;暂时性尿失禁2例,附睾炎1例.所有病例均痊愈出院,术后无复发. 结论开放性手术治疗前列腺增生症并巨大膀胱憩室,具有疗效确切,安全可靠,死亡率低等优点,适用于基层.     

膀胱纤维瘤1例报告

1　临床资料我院泌尿外科于 2 0 0 2年 2月间收治膀胱纤维瘤 1例 ,现报告如下。患者 ,女性 ,37岁 ,于入院前一周无明显诱因出现全程肉眼发热血尿 ,并排出大量血块 ,伴有排尿困难及明显的尿频、尿急 ,无及腹部疼痛 ,在当地给予抗炎、止血及对症处理后症状消失。B超提示 :膀胱内占位病变 ,不随体位移动 ,左肾轻度积水。膀胱镜下观察 :膀胱左侧壁可见 3.5cm× 4.2cm肿瘤 ,左侧输尿管口不清楚 ,瘤体表面光滑 ,可见粗大的血管 ,血运丰富 ,易出血 ,基地部宽。于 2 0 0 2年 2月 2 8日在硬膜外麻醉下行膀胱肿瘤切除术 ,术中所见与膀胱镜下发现相同 …     

原发性膀胱印戒细胞癌1例

 目的 探讨原发性膀胱印戒细胞癌的临床特点、诊疗方法。方法 报告1例原发性膀胱印戒细胞癌患者的临床特征及诊治方法,结合文献进行复习。结果 患者术前经活检明确诊断为膀胱印戒细胞癌,相关检查排除转移性印戒细胞癌,行经腹腔镜全膀胱切除及盆腔淋巴结清扫术。术后予以全身化疗。结论 原发性膀胱印戒细胞癌临床表现及影像学特征缺乏特征性,恶性程度高,预后差,早期行根治性膀胱切除术,结合全身化疗等治疗效果较好。     

前列腺增生症并巨大膀胱憩室手术疗效

目的：探讨同时切除膀胱憩室、前列腺增生症的手术效果。方法：对前列腺增生症伴发巨大膀胱憩室40例，均行耻骨上经膀胱憩室及前列腺摘除术，术后留置气囊导尿管及膀胱造瘘管，持续冲洗膀胱至尿液转清。结果：术后出血致膀胱内血块堵塞需再次手术者2例；术后伤口感染3例；暂时性尿失禁2例，附睾炎1例。所有病例均痊愈出院，术后无复发。结论：开放性手术治疗前列腺增生症并巨大膀胱憩室，具有疗效确切，安全可靠，死亡率低等优点，适用于基层。     

膀胱侵袭性血管黏液瘤1例及文献复习

侵袭性血管黏液瘤（aggressive angionyxoma,AAM）是由Steeper等于1983年首先提出的,是一种少见的低度恶性肿瘤,现报道1例发生于膀胱的AAM并进行文献复习。     

膀胱良性肿瘤30例的诊断及治疗

目的探讨膀胱良性肿瘤的诊断及治疗方法。方法对30例膀胱良性肿瘤病例进行回顾性分析。结果 30例术前依靠B超、尿路造影、CT、膀胱镜检查加活检及术后病理明确诊断为乳头状瘤6例（伴非典型增生2例）,内翻性乳头状瘤16例（伴非典型增生5例）,平滑肌瘤7例,嗜铬细胞瘤1例,视肿瘤具体情况分别采取TURBT术、膀胱部分切除术、膀胱肿瘤剜除术,术后定期膀胱镜检查,随访3个月～2a,未见复发病例。结论膀胱良性肿瘤病理类型较多,术前诊断主要依靠影像学检查及膀胱镜检查,B超为重要的筛查方法,而确诊则有赖于术后的病理检查,乳头状瘤及内翻性乳头状瘤治疗首选TURBt术,平滑肌瘤则常需行膀胱部分切除术。对伴有非典型增生病例,术后常规采用规则膀胱内灌注化疗,可降低肿瘤复发率及防止癌变。     

Perivascular epithelioid cell tumor of the pancreas: case report and literature review

Neoplasms with perivascular epithelioid cell differentiation (PEComas) of the pancreas are rare, and only 22 cases have been reported globally. Therefore, clinician and pathologist knowledge of this tumor’s biologic behavior and molecular genetics has been limited. A 40-year-old female patient presented with a space-occupying mass in the pancreas found by abdominal B-mode ultrasonography upon physical examination. Laparoscopic resection of the pancreatic body and tail was performed, and a cystic-solid tumor of about 2 × 2 cm was identified. PEComa is a type of mesenchymal tumor with uncertain biologic behavior, more frequently found in females. PEComa features a unique histomorphology and immunophenotype. We summarize the characteristics and research progress of the pancreatic PEComa, which will be convenient for physicians and pathologists to fully understand the disease to avoid misdiagnosis and to provide a reference for treatment and prognosis.     

膀胱小细胞神经内分泌复合癌1例报道及文献复习

目的：研究膀胱小细胞神经内分泌复合癌（ＳＣＮＥＣＣ）的临床病理特征及生物学行为。方法：采用光镜、电和免疫细胞对１例膀胱ＳＣＮＥＣＣ进行观察及行随访。结果本例肿瘤组织由小细胞神经内分泌癌，移行细胞癌及腺中闾民分构成。电镜下在小细胞癌人可找见神经内分泌颗粒，免疫组化ＮＳＥ阳性。术后３个月发生肝与肩胛骨转移，１３个月死于肝功能衰竭。结论：ＳＣＮＥＣＣ是一罕见高度恶性肿瘤，有独特的病理形态，早期即可发生侵     

胰腺实性假乳头状瘤1例并文献复习

胰腺实性假乳头状瘤(solid-pseudopapillary tumor of pancreas,SPTP)是一种极其少见的低度恶性肿瘤,好发于年轻女性,常常易被误诊为良性疾病,临床表现没有明显的特异性,主要是腹痛,诊断和鉴别诊断依靠其临床特征、影像学表现、病理组织学特点及免疫组织化学结果,首选治疗方法是手术切除,这类病人大多预后良好.     

Posterior choroidal leiomyoma: a rare case report and literature review

We report a literature review and detailed evaluation of a rare case of posterior choroidal leiomyoma to emphasize the importance of differentiating this from other choroidal tumors. A 30‐year‐old male presented with variable blurred vision in his right eye secondary to a choroidal tumor. Clinical examinations were performed including fundus photography, optical coherence tomography, B scans, fluorescein and indocyanine green angiography, computed tomography, and magnetic resonance imaging. Preoperative examination revealed a suspected choroidal melanoma and enucleation was performed. However, a definitive diagnosis of choroidal leiomyoma was made following postoperative pathological light microscopy and immunohistochemical studies. Published case reports were collected and the common characteristics and distinctive features were compared with the current case. Posterior choroidal leiomyoma was summarized from the literature, and beneficial information for diagnosis and treatment was obtained. In conclusion, posterior choroidal leiomyoma is rare and should be differentiated from amelanotic melanomas. Despite the benign nature, an explanation regarding the rare incidence and difficult diagnosis of posterior choroidal leiomyoma must be provided to patients, prior to enucleation or detrimental treatment.     

Paratesticular solitary fibrous tumor: a case report and review of literature

Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually arising from the pleura, but has been reported in diverse extrapleural sites. Urogenital localization is rare, and only several cases of paratesticular SFT have been reported. In the present report, we present the case of a 61-year-old male suffering from a paratesticular SFT. A surgical excision of the lesion was performed. The tumor was well circumscribed and consisted of a mixture of bland spindle cells and dense collagen bands. Immunohistochemical studies showed positive reactivity for CD34, CD99 and vimentin, but stained negative for CD117, S100, SMA, HMB45, Desmin and CD68. All these clinicopathologic features are suggestive of the diagnosis of paratesticular SFT.     

婴儿色素性神经外胚瘤1例报道并文献复习

目的 探讨婴儿色素性神经外胚瘤的临床病理特征、免疫组化、诊断和鉴别诊断要点。方法 对1例婴儿色素性神经外胚瘤进行组织学和免疫组化观察和文献复习。结果 婴儿色素性神经外胚瘤好发于1岁以内的婴儿,肿瘤多见于上颌骨和颅骨,表现为浸润性和溶骨性破坏。组织学上显示大的并含不等量色素颗粒的上皮样细胞和小的神经母细胞样细胞。免疫组化显示CK、HMB-45、S-100蛋白、NSE在上皮样细胞呈阳性表达,小圆形瘤细胞S-100蛋白、NSE阳性或部分阳性。肿瘤彻底切除,随访3年未发现转移和复发。结论 婴儿色素性神经外胚瘤是一种少见的起源于神经嵴细胞的肿瘤,具有特征性的临床病理改变,需要和神经母细胞瘤、恶性黑色素瘤及其它小圆细胞肿瘤鉴别,生物学行为属于潜在恶性或低度恶性肿瘤,彻底切除预后良好。     

A giant ureteral polyp mimicking as a bladder mass resected ureteroscopically by diode laser: a case report and literature review

We presented a rare case with giant ureteral polyp that mimics bladder tumor in adult women, originating from the middle segment of the left ureter. The patient was a 42-year-old woman, with a 2.1×1.3 cm bladder mass detected incidentally on a health screening ultrasound. Computerized tomography (CT) of the pelvis revealed a solid tumor situated near to trigon. Cystoscopy demonstrated a tumor that periodically prolapsed into the bladder. After the tumor was identified as a ureteral polyp by ureteroscopy, an ureteroscopic resection by diode laser was performed. The tumor measured 9.0×0.5 cm, and the final pathological diagnosis was ureteral fibroepithelial polyp. No recurrence was observed at the 5-month follow-up.     

颈静脉球瘤1例及副神经节瘤文献复习

目的探讨颈静脉球瘤的临床病理特征和副神经节瘤的生物学行为。方法对1例颈静脉球瘤进行组织学观察和免疫组化标记,同时复习相关文献。结果颈静脉球瘤的组织学改变类似于其他部位的副神经节瘤,免疫组化标记:瘤细胞Syn、CgA和NSE均阳性,EMA、CK、HMB45、CD34和CD99均阴性。结论颈静脉球瘤是一种起源于副神经节的少见肿瘤,呈侵袭性生长,有低度恶性的生物学行为。根据肿瘤的组织学特征,结合CT或MR I影像学资料和免疫组化标记可以作出诊断。     

Periosteal osteoblastoma: a case report and a review of the literature

Osteoblastomas located on the surface of cortical bone, so-called periosteal (juxtacortical) osteoblastomas, are extremely rare. A 24-year-old man complained of pain and swelling in the left knee. The clinical and radiological investigation showed a tumor located in the posterior portion of the distal shaft of the femur. The radiological differential diagnosis included parosteal osteosarcoma, periosteal chondroma and periostitis ossificans. A frozen section was obtained and histology revealed an osteoblastoma with large epithelioid-appearing osteoblasts consistent with an aggressive osteoblastoma. An en bloc resection of the tumor was performed and the definitive histology of the whole specimen revealed a typical osteoblastoma. The authors draw attention to the fact that periosteal osteoblastoma is a rare tumor that could be mistaken clinically and histologically for other and more common tumors at this location.     

Sarcomatoid carcinoma with small cell carcinoma component of the urinary bladder: a case report with review of the literature

Sarcomatoid carcinoma of the urinary bladder is an uncommon neoplasm characterized histopathologically by the presence of malignant spindle cell and epithelial components. Albeit extremely rare, sarcomatoid carcinoma with small cell carcinoma has been reported. Herein, we describe an additional case of sarcomatoid carcinoma with small cell carcinoma and squamous cell carcinoma of the urinary bladder and review the clinicopathological features of this type of tumor. An 82-year-old Japanese male presented with hematuria. Computed tomography demonstrated a large tumor in the urinary bladder. Histopathological study of the resected urinary bladder tumor showed that approximately 80% of the tumor was comprised of small cell carcinoma, and the remaining components were spindle cell proliferation (approximately 15%) and squamous cell carcinoma (5%). Both the spindle cell and squamous cell carcinoma components were intermingled with nests of the small cell carcinoma. This is the fifth documented case of sarcomatoid carcinoma with small cell carcinoma of the urinary bladder. Our review of the clinicopathological features of this type of tumor revealed that: i) elderly males are mainly affected, ii) the most common chief complaint is hematuria, iii) the epithelial component may include urothelial carcinoma, adenocarcinoma, and/or squamous cell carcinoma, and iv) the sarcomatous component is composed of spindle cell proliferation. The histogenesis of this type of tumor remains a matter of controversy. However, recent molecular analyses demonstrated a monoclonal origin of both components. This theory can account for the various types of carcinomatous components in this tumor as seen in the present case.