嗜酸性膀胱炎二例报告并文献复习  

Eosinophilic cystitis (report of 2 cases and review of the literature)

作　　者：陶然[1] 张春宇[1] 邓飞[1] 杨金强[1] 刘金[1] 刘显福[1] 司廷臣[2] 

机构地区：[1]北京顺义医院泌尿外科,101300 [2]北京顺义医院病理科,101300

出　　处：《中华泌尿外科杂志》2006年第3期191-193,共3页Chinese Journal of Urology

摘　　要：目的探讨嗜酸性膀胱炎的临床表现、病理特点和诊治方法。方法对嗜酸性膀胱炎2例进行临床分析并结合文献复习，从临床表现、病理特点和诊治方法及疗效等方面总结。例1，男，63岁，主要表现为无明显诱因出现间断性肉眼血尿，伴尿频、尿急、排尿困难和腹痛。无明显过敏史，膀胱镜检查示膀胱底部有5cm×3cm范围增生隆起，高出黏膜0．2—0．4cm。例2，女，42岁，无明显诱因出现尿频、尿急、排尿困难和耻骨上疼痛并伴间断血尿，无明显过敏史，膀胱镜检查见膀胱底及膀胱颈部菜花样肿瘤病变，大小约4cm×3cm×2cm，高出黏膜0．3—0．4cm。B超、CT及IVU等影像学检查2例均表现为膀胱壁增厚和占位性病变。2例均行经尿道病变电切术并辅以皮质激素、抗生素治疗。结果2例患者术后病理均为嗜酸性膀胱炎。术后随访6个月，排尿异常症状消失，B超、CT及IVU等影像学及膀胱镜检查未见膀胱占位性病变。结论嗜酸性膀胱炎临床少见，易误诊为膀胱肿瘤，膀胱镜检查与组织活枪和切除组织的病理检查是诊断的必要步骤，治疗方法包括经尿道膀胱病变切除术并辅以非特异性的药物治疗。Objective To evaluate the clinical presentations,pathologic characteristics,and the diagnosis and treatment of eosinophilic cystitis. Methods Two cases of eosinophilic cystitis were analyzed, and the relevant literature was reviewed. Case 1, a 63-year-old man, complained of voiding urgency and frequency, dysuria, intermittent hematuria,and lower abdominal pain. Cystoscopic examination showed that an about 5cm × 3cm abnormal focus was 0.2 -0.4 cm above bladder mucosa at the fundus of the bladder. Case 2,a 42-year-old woman, complained of voiding urgency and frequency, dysuria, and suprapubic pain with intermittent hematuria. Cystoscopic examination showed that about 4 cm × 3 cm ×2 cm abnormal foci of cauliflower-like were 0.3 - 0.4 cm above bladder mucosa at the fundus and neck of the bladder. Imaging examinations （ B-ultrasound, CT and IVU） showed diffuse thickening of bladder wall and tumor-like lesions. They both underwent transurethral resection of the lesions and were treated with oral steroids and antibiotics. Resuits Postoperative pathology confirmed eosinophilic cystitis in both cases. The follow-up was 6 months. The voiding symptoms disappeared, and imaging examinations showed no space-occupying lesions of the bladder in them. Up to now,there has no evidence of relapse. Conclusions Eosinophilic cystitis is a very rare tumor-like inflammatory disease. It is easily misdiagnosed as bladder neoplasm. Cystoscopy and biopsy are gold standard for the diagnosis. Current treatment modalities include transurethral resection of the bladder lesion along with non-specific medical therapy.

关 键 词：膀胱炎 嗜酸细胞 病理学 活组织检查 

分 类 号：R694[医药卫生—泌尿科学]