膀胱软斑病1例报告

1病例摘要 患者女，53岁。无痛性肉眼血尿2个月入院治疗。临床检查：右肾积水，左肾缺如。膀胱镜检查见膀胱内炎性肉芽组织增生，行手术切除。术中见膀胱黏膜为一层黄白色絮状物质所覆盖，肿物与膀胱黏膜无明显黏连。可行剥离，剥离面可见出血点。絮状物切除送病理检查。病理检查所见：镜下见被覆移行上皮黏膜组织，黏膜下可见弥漫性增生的上皮样组织细胞，胞浆嗜酸或嗜双色性，其内可见散在圆形或卵圆形包涵体（MG）小体，嗜碱件，呈同心圆状钙化小体，分散在间质及组织细胞内。间质内可见多数炎细胞浸润及淋巴组织增生，伴有生发中心形成。MG小体PAS，铁及钙染色阳性。病理诊断：膀胱软斑病。     

肾脏软斑病1例报告

患者 ,男 ,1 5岁。因左腰部隐痛 1 0 d,于 1 998年4月收入院。患者无尿频、尿急、尿痛及血尿。体检 :双肾区未扪及肿物 ,双肾区无叩击痛 ,沿输尿管区无压痛 ,膀胱区无压痛。尿常规未见异常 ,血常规 :WBC8.7× 1 0 9/L,N0 .77。 B超示左肾下极有一5 .3cm× 3.5 cm× 3.3cm低回声占位病变 ,边界不清。CT检查示左肾轮廓不清 ,其下极密度不均。胸部 X线片未见异常。IVU示左肾中下盏受压。术前诊断 :左肾肿瘤。于 1 998年 5月 1 2日在硬脊膜外腔麻醉下行左肾肿瘤探查术 ,术中见肿瘤位于左肾中下部 ,包膜完整。将左肾及部分输尿管一并切除。…     

附睾软斑病1例

患者,男,49岁。右侧阴囊肿痛12 d。久站久行后肿痛加重,无发热、畏寒。体检:阴囊皮肤不红,局部触之不热,透光试验阴性,右阴囊内可触及8 cm×5 cm×5 cm不规则肿物,呈结节状,质韧,与阴囊皮肤无粘连,触痛,睾丸及附睾触诊不满意,右精索增粗,直径0.6 cm,质硬,无念珠样改变。B超:右侧睾丸及附睾体积增大,呈结节状,密度不     

前列腺软斑病1例报告

前列腺软斑病是一种罕见的慢性肉芽肿炎症性疾病,Von Hansemann于1901年首次报道了这种疾病[1].目前国内文献报道仅有30余例,且多数受累部位为膀胱,前列腺软斑病比较少见,对其临床特点及病理学的描述也相对较少[2].现报告1例前列腺软斑病如下.     

肾脏软斑病侵犯降结肠合并膀胱软斑病1例报告

软斑病是一种主要发生于泌尿系统的罕见肉芽肿性病变, 而肾脏软斑病侵犯降结肠同时合并膀胱软斑病更罕见, 本研究报道1例。影像学检查示左肾大片状混杂密度影, 增强扫描病灶呈不均匀强化, 行CT引导下肾穿刺活检术, 术后病理结果示肾脏软斑病。行经尿道膀胱镜检查, 活检病理证实为膀胱软斑病。予抗生素保守治疗, 效果欠佳。患者行根治性肾切除术+左半结肠切除术, 术后病理确诊为肾脏软斑病, 病变累及肠管黏膜及整个肌层。术后随访6个月, 行CT检查未见复发。     

前列腺软斑病

目的 探讨前列腺软斑病的诊断和治疗方法,方法 报告２例前列腺软斑病并综合文献复习对其病因,发病机制,临床表现,诊断等进行分析。结果 前列腺软斑病多与感染及免疫障碍有关,是可治愈的炎性病变,但临床上易与前理腺癌相混澹而行根治性前列腺切除术。结论 前列腺穿刺活检及抗炎治疗是诊治前列腺软斑病的可靠方法。     

前列腺软斑病1例报告并文献复习

目的 探讨诊治前列腺软斑病的方法 和效果.方法 回顾我院诊治的1例前列腺软斑病患者,并进行文献复习.结果 本例患者经病理检查明确诊断,并行经尿道前列腺汽化电切术及抗生素治疗后痊愈.该例发热并有排尿困难及尿痛症状,细菌培养阳性,病理切片可见软斑细胞及M-G小体.结论 前列腺软斑病是一种可治愈的炎症性疾病,多伴随免疫功能障碍,诊断上需病理检查明确并与前列腺癌相鉴别,治疗上可行经尿道前列腺电切术或开放前列腺摘除术,以及敏感抗菌素等药物治疗.     

脐尿管软斑病累及膀胱1例报告

软斑病是一种罕见的慢性肉芽肿性病变, 临床误诊率极高, 本文报道1例脐尿管软斑病累及膀胱。患者外院检查发现膀胱前上方与腹壁间占位性病变, 行增强CT检查示脐尿管病灶累及膀胱顶壁, 膀胱顶壁不规则样增厚、强化。行脐尿管肿瘤根治术+膀胱部分切除术, 术后予抗菌药物治疗。病理诊断为脐尿管、膀胱软斑病。术后随访18个月, 无局部复发及转移。     

睾丸、附睾软斑病2例

例 1 　 男 ,45岁。因右侧睾丸肿大 3年余于1 998年 1 2月 4日入院。 3年前患者右侧睾丸肿胀、疼痛 ,伴畏寒、发热 ,曾在当地医院以“睾丸炎”给予药物治疗 (药名不详 ) ,后右睾丸肿痛消失。以后自觉右侧睾丸逐渐长大 ,伴坠痛感。体检 :右侧睾丸肿大 ,可扪及 1 0 cm× 8cm肿物 ,质硬 ,表面不光滑 ,睾丸、附睾界限不清 ,触之有轻微疼痛 ,透光试验(- )。B超检查显示肿物呈低密度结节状 ,其内密度不均。血、尿常规正常。拟诊右侧睾丸肿物。术中见肿物大小为 1 0 cm× 8cm,呈结节状 ,质韧 ,黄褐色 ,鞘膜脏层和壁层粘连。病理检查 :送检一侧睾丸…     

前列腺软斑病2例

<正>例1,男,72岁。因进行性排尿困难8年余,尿痛伴发热5天于2009年11月16日入院。既往症状发作时经导尿及抗感染治疗后症状缓解。5天前无明显诱因出现尿痛伴发热。体检:体温38.4℃;直肠指检:前列腺Ⅲ度肿大,中间沟消失,质稍硬,表面结节状,有明显触痛;B超检查:前列腺体积约5.1cm×4.5cm×4.1cm,左叶腺内有一直径1.6cm的低回声结节,剩余尿量63ml。血常规:WBC 15.3×109/L;尿常规:白细胞(+++),     

Renal malakoplakia as a pseudotumoral lesion in a renal transplant patient: A case report

Malakoplakia is a rare chronic inflammatory disease associated with gram-negative bacterial infections frequently caused by Escherichia coli. Malakoplakia usually affects the lower urinary tract (bladder) but there are cases described in the kidney as well as in the respiratory and digestive organs. We report on a case with renal parenchymal malakoplakia in a renal transplant patient and describe the pathological lesions of malakoplakia: histiocytic proliferation with scarce inflammatory infiltrate, histiocytes with acidophilic cytoplasm and the presence of characteristic Michaelis-Gutmann bodies. The authors in this study review the updated reports related to the entity in this uncommon localization, the association with an immunocompromised patient, the macroscopic presentation as a pseudotumoral lesion and the possible relationship with the xanthogranulomatous pyelonephritis as a form of a histopathological spectrum in patients affected with gram negative urinary tract infection.     

Genitourinary malakoplakia in women—A review

The pathogenic, diagnostic and therapeutic aspects of malakoplakia are reviewed, with special reference to its clinical presentation in women. This presentation varies depending on the site of origin, the extent of the lesions and the predominance of symptoms. Women over 40 years old with a history of recurrent cystitis, occasional self-limiting hematuria and irritative micturition syndrome are identified as a risk group for bladder malakoplakia. The diagnostic approach consists of cystoscopy, cytology and/or biopsy, identifying the characteristic pathological findings: histiocytes with Michaelis-Gutmann bodies. Treatment is based on two criteria: medical, with antibiotics, ascorbic acid and cholinergic agents, and surgical, with extirpation of the plaque by transurethral resection or by open surgery.     

系统性硬化并发急性肾损伤的临床病理分析

目的 探讨系统性硬化（SSc）急性肾损伤（AKI）患者的临床和病理特点。方法 回顾性分析11例SSc急性肾损伤患者的临床资料，比较抗中性白细胞胞质抗体（ANCA）阳性和阴性SSc患者的肾脏损伤情况。结果 11例SSc急性肾损伤患者中，ANCA阴性9例，6例临床表现为硬皮病肾危象（SRC），其中4例肾活检示小叶间动脉和人球小动脉内皮细胞增生、肿胀，内膜黏液性水肿，内弹力纤维断裂，“洋葱皮样”改变和肾小球弥漫性缺血；无恶性高血压表现2例；急性肾小管坏死1例。MPO-ANCA阳性2例，无恶性高血压表现，1例肾活检示新月体肾炎。所有病例均予糖皮质激素治疗，8例患者接受环磷酰胺（CTX）治疗，9例患者接受血液透析治疗。SRC的6例患者都接受了大剂量的ACEI和（或）ARB治疗，其中4例于6个月内死亡，余ANCA阳性和阴性的患者中也各有1例死亡。结论 SSc患者AKI的临床表现多样，SRC、ANCA相关性小血管炎都可能导致SSc患者急性肾损伤发生，两者在临床、肾脏病理及治疗方面有明显的不同，但预后都不良。大剂量糖皮质激素有诱发SRC的可能，建议泼尼松用量〈15mg／d。     

系统性硬化病患者足部创面修复1例

<正>患者,女,43岁,因系统性硬化病20年、双足皮肤缺损6月余入院。患者20年前无明显诱因出现雷诺现象,双手遇冷后会变白变紫,保暖后可好转,后逐渐出现四肢指(趾)端皮肤肿胀、僵硬及萎缩,并向近心端蔓延,进食时有梗咽感并伴有四肢散在红斑,后逐渐出现口干、眼干及负重时胸闷气促感,在外院     

Concomitant presence of bladder cancer and neurogenic bladder in a patient with HTLV-1 carrier: A case report

We describe a case of an HTLV-1 carrier who developed bladder cancer and neurogenic bladder. HTLV-1 is thought to alter host immune function and to contribute to the development of other malignancies. It is also sometimes reported that urinary symptoms precede pyramidal symptoms in patients with HAM. To our knowledge, concomitant presence of bladder cancer and neurogenic bladder in an HTLV-1 carrier has not been previously reported. This revised version was published online in August 2006 with corrections to the Cover Date.     

慢性髋部骨髓炎合并膀胱瘘及膀胱结石1例

患者,男,52岁。因右下肢跛行30年余,右髋外侧流清液10年伴疼痛2个月入院。自诉30年前因右髋外伤行关节手术,术后伤口愈合但跛行,10年前右髋关节外侧开始出现渗液,无尿急、尿痛,髋关节疼痛可忍,未处理,2个月前右髋疼痛伴跛行加重。右髋关节外侧见一纵形切口瘢痕,局部皮肤色素沉着,大转子下1 cm见一渗液瘘口,直径约1 cm,瘘口周围皮肤质硬,右腹股沟区深压痛但无波动感,右髋活动明显受限,Thom as征阳性,右下肢较健侧短缩约4 cm。右耻骨区及耻骨左上区压痛。外阴正常。骨盆X线片示(图1):右侧耻骨及坐骨支大部分破坏,股骨头缺损,股骨颈残缺不整,…     

Foreign body in the bladder: A case report

Foreign bodies are occasionally reported in the bladder. In most cases, the foreign body is removed via the transurethral approach. A 57-year-old male patient was referred to our hospital to undergo the retrieval of a foreign body from his bladder. However, the foreign body had become severely calcified and could not be removed transurethrally. Thus, an open bladder wall incision was necessary to remove it. We herein report a case of a foreign body in the bladder that had become calcified and which was successfully removed using a higher bladder incision approach. A careful preoperative examination should be performed to detect the characteristics of the foreign body and avoid the risk of bladder wall perforation.     

Spinal anaesthesia for Caesarean section in a patient with systemic sclerosis

We describe the management of a diabetic primigravid woman with systemic sclerosis and thrombocytopaenia who required Caesarean section for pre-eclampsia. This was performed successfully under spinal anaesthesia.     

膀胱结石并发膀胱鳞状细胞癌28例报告

目的提高膀胱结石并发鳞癌的诊治水平。方法回顾分析28例膀胱结石并发膀胱鳞状细胞癌的临床资料,男19例,女9例。年龄26~68岁,平均33岁。膀胱结石病程2~18年,平均4.5年。24例行尿细胞学检查发现异形细胞19例。KUB示膀胱单发结石5例,多发结石23例,IVU提示膀胱占位性病变者11例,B超和CT示膀胱占位性病变者17例。行膀胱镜检查28例发现膀胱肿瘤21例,肿瘤大小1.2cm×1.5cm~2.2cm×5.0cm。21例行膀胱部分切除术,其中6例行输尿管膀胱移植术。7例行全膀胱切除术。结果病理报告均为膀胱鳞状细胞癌;G111例,G212例,G35例;T111例,T212例,T35例。22例获随访1~8年,平均3年,1年和5年生存率分别为63.6%(14/22)和16.7%(3/18)。结论膀胱结石并发膀胱鳞癌恶性程度高,早期诊断和手术治疗极其重要。     

Unexpected foreign body in the bladder of a spinal cord injured patient: A case report

Context: Bladder dysfunction is common in patients with spinal cord injuries. Clean intermittent catheterization is a preferred method of neurogenic bladder management among spinal cord injured patients. Some complications may occur due to the use of clean intermittent catheterization.

Findings: In this report, we presented a case with an unexpected foreign body detected in the bladder of a patient who used to perform clean intermittent catheterization for her neurogenic bladder management, to our knowledge, which has not been reported in the literature so far.

Conclusion/Clinical Relevance: In this case report, we want to emphasis the importance of different kind of foreign bodies remaining in the bladder during clean intermittent catheterization.