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目的探讨膀胱假肉瘤性肌纤维母细胞增生的临床病理特征。方法3例膀胱肌纤维母细胞增生光镜和免疫组化检查。结果3例均为男性,年龄分别45、46、55岁,主要临床症状为无痛性血尿和排尿困难,无外伤史,随访3～6个月无复发。组织学检查:病变主要由松散排列的梭形细胞区,可见节细胞样细胞和致密条束状梭形细胞区,黏液样间质内弥漫分布急慢性炎细胞。分裂象3～5/10HPF,无不典型核分裂。病变主要发生在膀胱壁浅层,病变累及固有肌,出血明显。免疫表型:3例梭形细胞Vim和SMA弥漫阳性,MSA2/3例+>70%、Des+50%、CK+>70%、EMA+30%、ALK-1蛋白+70%、Ki-67+5%～20%、CD68、S-100蛋白、CD34均-。结论膀胱假肉瘤性肌纤维母细胞增生为一种良性非肿瘤性病变,复发率4.5%,要避免误诊为恶性。
Objective To investigate the clinicopathological features of pseudomyosoma myofibroblasts in bladder. Methods Three cases of myofibroblasts proliferated with light microscope and immunohistochemistry. Results All the 3 cases were male, with the ages of 45, 46 and 55 respectively. The main clinical symptoms were painless hematuria and dysuria without history of trauma. No recurrence was observed in 3 to 6 months follow-up. Histological examination: The lesion mainly consisted of loosely arranged spindle cells, ganglion cells and spindle-shaped spindle cells, and diffusely distributed acute and chronic inflammatory cells in the mucinous interstitium. Split like 3 ~ 5 / 10HPF, no typical nuclear fission. Lesions mainly in the superficial bladder wall, lesions involving the inherent muscle, bleeding significantly. Immunophenotype: Vim and SMA were diffusely positive in 3 cases of spindle cells, MSA2 / 3 cases> 70%, Des + 50%, CK +> 70%, EMA + 30%, ALK- 1 protein + 70%, Ki-67 + 5% ~ 20%, CD68, S-100 protein, CD34 are -. Conclusions Bladder pseudospatial myofibroblast hyperplasia is a benign non-neoplastic disease with a recurrence rate of 4.5%, to avoid misdiagnosis as malignancy.