膀胱软斑病6例临床病理分析及预后

目的探讨膀胱软斑病的临床病理特征、发病机制、鉴别诊断及预后。方法对6例膀胱软斑病患者的临床特征、影像学及组织病理学表现进行分析,并复习相关文献。结果组织学形态均可见成片组织细胞样细胞分布,散在淋巴细胞,浆细胞浸润。组织细胞内外部分可见靶环或枭眼状的Michaelis-Gutmann小体(M-G小体即软斑小体)。PAS和普鲁士蓝铁染色阳性。免疫组化CD68弥漫(+),CK(-),Ki-67增殖指数为10%。随访3~18个月,均预后良好。结论软斑病是一种少见的慢性肉芽肿性炎症疾病,全身均可受累,且以泌尿系统(膀胱)最常见。因影像学多表现为实质性占位,而易误诊为肿瘤。病理诊断为金标准,可采用抗生素、手术及免疫治疗相结合的综合治疗方案进行治疗。

Clinicopathological Characteristics and Prognosis of Bladder Malakoplakia:Analysis of 6 Cases

Objective To explore the clinical pathological features,differential diagnosis and prognosis of bladder Malakoplakia. Methods The analysis of clinical,radiological,histopathological and immunohistochemical features of 6 cases of bladder Malakoplakia have been made. And relevant literatures review have been performed. Results The histologigic examination of the biopsy specimen re-vealed sheets of histiocytes containing abundant eosinophihc cytoplasm and chronic inflammatory infiltrates of plasma cells and lympho-cytes. Outsides of histiocytoid cell,we can find Michaelis-Gutmann bodies( M-G bodies),which look like“owl-eye cell”and“tar-getoid appearance cell”. And they were positive with Prussian blue( for iron)and periodic acid-Schiff staining. Immunohistochemical-ly,histiocytes were positive for CD68 and negative for CK,Ki-67 index was about 10%. Conclusion Malakoplakia is a rare granulom-atous disease that most commonly occurs in the urinary tract. Malakoplakia is always misdiagnosed as a malignant disease because of its radiological occupying performance. And its gold standard is pathology. A comprehensive treatment of antibiotic,surgical and immuno-therapy used to be performed.