临床与病理杂志
臨床與病理雜誌
림상여병리잡지
International Journal of Pathology and Clinical Medicine
2015年
6期
978-984
,共7页
膀胱%嗜铬细胞瘤%临床病理分析
膀胱%嗜鉻細胞瘤%臨床病理分析
방광%기락세포류%림상병리분석
bladder%pheochromocytoma%clinicopathological study
目的：探讨膀胱嗜铬细胞瘤的临床病理学特征、病理诊断以及鉴别诊断。方法：搜集14例膀胱嗜铬细胞瘤患者的临床病理资料，回顾性总结膀胱嗜铬细胞瘤的临床及病理学特征，复习相关文献。结果：14例患者中男性8例、女性6例；年龄14~63岁，平均年龄46.7岁。肿瘤最大径从0.2~8 cm不等，平均最大径2.5 cm。以排尿后头痛、心悸、血压升高为临床主要症状。镜下可见较一致的多边形或圆形上皮样肿瘤细胞，排列成条索、巢团及片状结构，形成典型的zellballen细胞巢，无包膜，在膀胱壁中浸润性生长；肿瘤间质富含薄壁血管，大部分血管呈血窦状、无显著扩张；大部分细胞较一致，散在少数胞体形状不规则、核大深染的瘤细胞，部分胞浆略嗜碱性，核分裂罕见，瘤巢周边见散在梭形细胞。免疫组织化学显示肿瘤细胞CgA、Syn阳性，增殖指数Ki-67阳性1%~10%不等，瘤巢周边梭形细胞S-100阳性；瘤细胞AE1/AE3阴性。9例采用经尿道膀胱肿物切除，其中4例复发。5例采用膀胱部分切除术，其中2例复发。结论：膀胱嗜铬细胞瘤是发生于膀胱的罕见肿瘤，需要依赖组织形态与免疫组织化学特点与其它膀胱肿瘤进行鉴别诊断；单纯肿瘤切除容易局部复发，引起转移的恶性病例少见。
目的：探討膀胱嗜鉻細胞瘤的臨床病理學特徵、病理診斷以及鑒彆診斷。方法：搜集14例膀胱嗜鉻細胞瘤患者的臨床病理資料，迴顧性總結膀胱嗜鉻細胞瘤的臨床及病理學特徵，複習相關文獻。結果：14例患者中男性8例、女性6例；年齡14~63歲，平均年齡46.7歲。腫瘤最大徑從0.2~8 cm不等，平均最大徑2.5 cm。以排尿後頭痛、心悸、血壓升高為臨床主要癥狀。鏡下可見較一緻的多邊形或圓形上皮樣腫瘤細胞，排列成條索、巢糰及片狀結構，形成典型的zellballen細胞巢，無包膜，在膀胱壁中浸潤性生長；腫瘤間質富含薄壁血管，大部分血管呈血竇狀、無顯著擴張；大部分細胞較一緻，散在少數胞體形狀不規則、覈大深染的瘤細胞，部分胞漿略嗜堿性，覈分裂罕見，瘤巢週邊見散在梭形細胞。免疫組織化學顯示腫瘤細胞CgA、Syn暘性，增殖指數Ki-67暘性1%~10%不等，瘤巢週邊梭形細胞S-100暘性；瘤細胞AE1/AE3陰性。9例採用經尿道膀胱腫物切除，其中4例複髮。5例採用膀胱部分切除術，其中2例複髮。結論：膀胱嗜鉻細胞瘤是髮生于膀胱的罕見腫瘤，需要依賴組織形態與免疫組織化學特點與其它膀胱腫瘤進行鑒彆診斷；單純腫瘤切除容易跼部複髮，引起轉移的噁性病例少見。
목적：탐토방광기락세포류적림상병이학특정、병리진단이급감별진단。방법：수집14례방광기락세포류환자적림상병리자료，회고성총결방광기락세포류적림상급병이학특정，복습상관문헌。결과：14례환자중남성8례、녀성6례；년령14~63세，평균년령46.7세。종류최대경종0.2~8 cm불등，평균최대경2.5 cm。이배뇨후두통、심계、혈압승고위림상주요증상。경하가견교일치적다변형혹원형상피양종류세포，배렬성조색、소단급편상결구，형성전형적zellballen세포소，무포막，재방광벽중침윤성생장；종류간질부함박벽혈관，대부분혈관정혈두상、무현저확장；대부분세포교일치，산재소수포체형상불규칙、핵대심염적류세포，부분포장략기감성，핵분렬한견，류소주변견산재사형세포。면역조직화학현시종류세포CgA、Syn양성，증식지수Ki-67양성1%~10%불등，류소주변사형세포S-100양성；류세포AE1/AE3음성。9례채용경뇨도방광종물절제，기중4례복발。5례채용방광부분절제술，기중2례복발。결론：방광기락세포류시발생우방광적한견종류，수요의뢰조직형태여면역조직화학특점여기타방광종류진행감별진단；단순종류절제용역국부복발，인기전이적악성병례소견。
Objective: To explore the clinicopathologic characteristics and histopathological diagnosis of bladder pheochromocytoma.Methods:A total of 14 cases of bladder pheochromocytoma were retrospectively retrieved from the surgical pathology ifles of Peking Union Medical College Hospital. hTe clinical and pathological ifndings were analyzed with a review of the literature.Results:Of the 14 patients with bladder pheochromocytoma, eight were males and six were females. hTe median age was 46.7 years (ranged from 14 to 63), and the median maximum diameter of the tumors was 2.5 cm (ranged from 0.2 to 8). Microscopic examination showed that the tumor cells were polygonal to spindle-shaped arranged into trabecular, solid or zellballen pattern in a rich vascular network. hTe tumor was typically not well circumscribed with inifltration of bladder wall. Immunohistochemical staining showed that CgA and Syn were positive for tumor cells, and S-100 was positive for the spindle cells around tumornests. AE1/AE3 was typically negative. Ki-67 index ranged from 1% to 10%. Nine cases received transurethral resection of bladder tumor, 4 cases of which had local recurrence. Five cases used bladder resection, 2 cases of which had local recurrence.Conclusion: Pheochromocytoma is a rare tumor of the bladder, and the pathological diagnosis is based on morphological and immunohistochemical characteristics. Local recurrence following tumor resection is common, while metastasis is rare.
