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患者,男,25岁,住院号285579.因间断浮肿、蛋白尿7a,肉眼血尿2月,于1994年11月10日入院.患者于7a前因面部及双下肢凹陷性浮肿半月来我院内科住院治疗.入院后诊断为原发性肾病综合征Ⅰ型,给予泼尼松40mg/d,环磷酰胺150mg/d,用药后28d尿蛋白转阴,泼尼松用至2个月后逐渐减量,至8个月时停药;环磷酰胺总量8g,用药后病情好转,各项临床检验指标恢复至正常.7a来常因感冒及劳累后病情复发,每次复发后自用泼尼松40mg/d,环磷酰胺每次复发应用8～9g,用法为150mg/d,口服.病情好转后泼尼松逐渐减量至停药.7a来共复发5次,发病来共应用环磷酰胺52g.2月前病人因受凉后又出现浮肿,伴肉眼血尿,带血丝及血块,无发热、腰痛及尿频尿急尿痛,亦无尿流中断,经用泼尼松、环磷酰胺后无效,来我院就诊,查尿蛋白(?)～(?),红细胞满视野,24h尿蛋白定量为7.6g;膀胱B超示膀胱内可见团块状物,考虑为陈旧性血块.静脉肾盂造影术中可见双肾显影可,膀胱区可见一巨大充盈缺损约5×7cm大,密度不均匀,边缘清晰,考虑为膀胱肿瘤.膀胱镜显示:膀胱后壁见一6×7cm大肿物,边缘不规则,表面有坏死及出血,考虑为膀胱乳头状癌.转外科行手术治疗,手术后诊断为膀胱乳头状癌,病理诊断为膀胱移行细胞癌,病人术后好转出院,定期随访.
Patients, male, 25 years old, hospitalization 285579. Due to intermittent edema, albuminuria 7a, gross hematuria in February, admitted to hospital on November 10, 1994. Patients with depression of the face and lower extremities in 7a before a half months to our hospital internal medicine Hospitalization diagnosis of primary nephrotic syndrome type Ⅰ, given prednisone 40mg / d, cyclophosphamide 150mg / d, 28d urine protein negative, prednisone with 2 months after the gradual decrease The amount of cyclophosphamide stopped 8 months, the total amount of cyclophosphamide 8g, the condition improved after treatment, the clinical test indicators returned to normal .7a often due to flu and exertion after the recurrence of the disease, each recurrence of prednisone 40mg / d, cyclophosphamide application of each recurrence of 8 ~ 9g, the use of 150mg / d, oral. After the condition improved prednisone tapering to withdrawal .7 a total of 5 relapsing, the incidence of a total of cyclophosphamide 52g.2 months before the onset of renal transplant cordoma appeared unmarried, with gross hematuria, bloodshot eyes and blood clots, no fever, low back pain and urinary urgency dysuria, no interruption of urinary flow, after prednisone, cyclophosphamide after invalid , To our hospital, check urinary protein (?) ~ (?), Full of red blood cells, 24h urinary protein was quantified 7.6g; bladder B ultrasound showed cystic mass, considered as Old blood clots. Intravenous pyelography can be seen in the development of the kidneys, the bladder area can be seen a huge filling defect about 5 × 7cm large, uneven density, clear edge, consider the bladder tumor. Cystoscopy showed: see a bladder wall 6 × 7cm large tumor, the edge of the irregular, the surface necrosis and bleeding, consider the bladder papillary carcinoma. Surgical treatment of surgery, postoperative diagnosis of bladder papillary carcinoma, pathological diagnosis of bladder transitional cell carcinoma, the patient improved after surgery Discharge, regular follow-up.