论文部分内容阅读
目的探讨膀胱绒毛状腺瘤的临床病理学特征、免疫组化、鉴别诊断及预后。方法收集4例膀胱绒毛状腺瘤患者的临床和病理资料,对其大体、组织学形态和免疫表型进行回顾性分析,并复习相关文献。结果 4例均为男性,年龄45~68岁,平均59岁。影像学检查示肿瘤均位于膀胱顶部或前壁。肿瘤由中央为纤维血管成分的绒毛状或分支乳头状结构及管状腺体组成。腺管内可见黏液分泌,乳头表面细胞呈单层高柱状,柱状上皮细胞间可见大量杯状细胞。其中2例为绒毛状腺瘤与低分化腺癌并存,肿瘤大部分区域为绒毛状腺瘤,局灶绒毛相互搭连成筛状结构,细胞异型性明显,核分裂象增多,并与浸润性低分化腺癌相移行。免疫组化示肿瘤villin、CK20和EMA(+),CDX-2和PSA(-)。结论膀胱绒毛状腺瘤较为少见,临床表现为膀胱内占位性病变的相关症状或体征,常伴发癌,因此临床需要完整切除并全部取材。
Objective To investigate the clinicopathological features, immunohistochemistry, differential diagnosis and prognosis of bladder villous adenoma. Methods The clinical and pathological data of 4 patients with bladder villous adenoma were collected. The gross, histological and immunophenotypes of the patients were retrospectively analyzed and the related literatures were reviewed. Results 4 cases were male, aged 45 to 68 years, mean 59 years. Imaging studies showed that the tumors were located on the top or anterior wall of the bladder. The tumor is composed of a villus-like or branched papillary structure with a central glandular fibroid component and a tubular gland. Visceral mucus secretion can be seen in the duct, nipple cells were monolayer columnar columnar columnar epithelial cells seen a large number of goblet cells. Two cases of villous adenoma and poorly differentiated adenocarcinoma co-exist, most of the tumor area is villous adenoma, focal villus interlinked into a sieve-like structure, cell atypia was obvious, increased mitosis, and invasive and low Differentiated adenocarcinoma phase shift line. Immunohistochemistry showed tumor villin, CK20 and EMA (+), CDX-2 and PSA (-). Conclusion bladder villous adenoma is relatively rare, the clinical manifestations of bladder lesions associated with signs or symptoms, often associated with cancer, so the need for complete removal of the clinical and all the material.