膀胱孤立性纤维性肿瘤 1 例报告并文献复习

目的:探讨膀胱孤立性纤维性肿瘤(solitary fibrous tumor，SFT)的临床表现、影像学表现、病理学形态、免疫表型、生物学行为、诊断、鉴别诊断、治疗方法及其预后。方法:回顾性分析 1 例膀胱 SFT 的临床资料、病理学形态、免疫表型、诊断治疗及随访情况，并结合国内外文献进行分析。结果:本例患者行根治性肿瘤切除术，肿瘤肉眼观表面光滑，切面灰白，质略韧，有包膜，无出血、坏死；镜检:肿瘤界清，无明显侵袭性，细胞稀少区与丰富区交替分布，以梭形细胞为主，核深染，染色质均匀；免疫表型:肿瘤细胞弥漫表达 CD34、Bcl-2；病理诊断为:（膀胱）孤立性纤维性肿瘤。术后随访 24 个月，体格检查正常，行盆腔 MRI 检查未见复发及远处转移。结论:膀胱SFT的诊断依赖临床表现、影像学以及病理组织学检查，确诊则须依靠病理学的免疫组化检查。膀胱 SFT生物学特性大多呈良性表现，根治性切除是主要治疗手段，但少数亦可局部复发或转变为恶性，故有必要对膀胱SFT患者术后进行长期随访。

A case report of solitary fibrous tumor of the bladder and literature review

Objective:To investigate the clinical manifestations,imaging findings,pathological morphology,immunohistochemistry biological behavior,diagnosis,differential diagnosis,treatment and prognosis of solitary fibrous tumor of bladder.Methods:The clinical data,pathological morphology,immunohistochemistry,diagnosis,treatment and follow-up of one case of bladder SFT were analyzed retrospectively.Results:This patient underwent radical tumor resection.The surface of the tumor was smooth.The section was gray and white.The substance was slightly tough,there was capsule,and there was no hemorrhage or necrosis.Microscopic examination showed the tumor was well defined with no obvious invasiveness and alternately distributed in the sparse and abundant areas,mainly spindle cells with deeply stained nuclei and homogeneous chromatin.Immunophenotype showed the tumor cells diffusely expressed CD34 and Bcl-2.The pathological diagnosis was (bladder) solitary fibrous tumor.With follow-up for 24 months,physical examination was normal.Pelvic MRI examination showed no recurrence and distant metastasis.Conclusion:The diagnosis of bladder SFT depends on the clinical manifestation,imaging and histopathological examination,and the definite diagnosis depends on the immunohistochemical examination of pathology.The biological characteristics of bladder SFT are mostly benign,and radical resection is the main treatment,but a few can also recur locally or turn into malignant,so it is necessary to follow up the patients with bladder SFT for a long time.