膀胱内翻性乳头状瘤15例报告及文献复习

目的 复习有关文献,对膀脱内翻性乳头状瘤(inverted papilloma,IP)的临床病理特征进行讨论,以提高对该病的诊断水平.方法 对15例膀胱IP患者的临床特征和病理形态改变进行分析.结果 15例中男12例,女3例.11例表现为无痛性肉眼血尿,4例男性有尿路刺激症状；13例发生于膀胱三角区,1例位于膀胱颈部,另1例位于膀胱侧壁.12例呈息肉状,2例呈半球状隆起,1例呈乳头状.病理组织学形态表现为移行上皮向固有层内形成小梁或成孤立的上皮巢,瘤细胞形态及排列结构规则,可见灶性鳞状或腺样化生,间质结缔组织较少.病理上最大的特征是肿瘤组织表面被覆一层正常移行上皮.结论 此瘤在临床和病理诊断中易误诊为癌,应结合临床特点与病理改变综合分析作出正确诊断.

Report of 15 cases of inverted papilloma of bladder and literature review

Objective To review the related literature, to discuss the clinical pathological characteristics of inverted pa- pilloma（IP） of bladder for improving its diagnostic level. Methods The clinical and pathomorphological characteristics in 15 of IP were analysized. Results Among 15 cases （ 12 males and 3 females ）, 11 cases were manifested by painless hematuria. 4 male cases showed the urethral irritating symptoms. 13 cases orginated from bladder triangle zone, 1 case located bladder neck, another ease on lateral wall. 12 cases were polypiform. 2 cases were hemisphere. 1 case was papillary. Pathohistologieal patterns were transitionary cells with small trahecular or solitary epithelial mass. Cell shape and tissue construction were regular. Foci squamous or adenoid metaplasia could be found. Connective tissues were rare. Histological feature was that the tumor was coated by normal transitional epithelial. Conclusion This tumor is easily misdiagnosed as carcinoma in clinic and the correct diagnosis depends on the synthetic analysis of clinical characters and pathological patterns.