膀胱肾源性腺瘤临床病理观察  

Nephrogenic adenoma of the urinary bladder: a case report and review of literature

作　　者：薛卫成[1] 钱利华[1] 沈丹华[1] 鲍冬梅[1] 廖松林[2] 

机构地区：[1]北京大学人民医院病理科,北京100044 [2]北京大学医学部病理学系,北京100083

出　　处：《诊断病理学杂志》2006年第5期351-353,I0010,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肾源性腺瘤的发病机制、临床病理、免疫组化特征、诊断和鉴别诊断等问题。方法对1例膀胱肾源性腺瘤进行临床病理和免疫组化观察及文献复习。结果70岁男性患者因肉眼血尿就诊,膀胱镜检查显示有一乳头状病变。活检发现肿瘤由成团的小管组成,被覆立方上皮细胞,部分小管囊性扩张,立方上皮细胞分化良好,无异型性,分裂象罕见。病变部位间质水肿,散在炎症细胞浸润,没有深层侵犯,组织学诊断为肾源性腺瘤。免疫组化:肿瘤细胞显示前列腺癌标记物P504S(+),基底细胞标记物p63(-)。易误诊为前列腺癌,鉴别点在于肾源性腺瘤高分子质量角蛋白34βE12(+),PSA(-)。Ki-67指数约为10%。结论肾源性腺瘤是一种易误诊的少见病变,掌握其组织学特点仍然是正确诊断的关键。Objective To explore the pathogenesis, clinicopathological and differential diagnosis of nephrogenic adenoma. Methods The chlincopathological and features, diagnosis and findings in a case of nephrogenic adenoma of the urinary bladder were presented with review of the relevant literature. Results A 70-year-old man presented to our institution with gross hematuria. Cystoscopy revealed a papillary lesion. Biopsy of the tumor showed aggregates of tubules lined with cuboidal epithelium. Some of the tubules were cystically dilated. The cuboidal cells had a bland morphology without atypia. Mitotic figures were rare. The stroma appeared edematous and contained scattered chronic inflammatory cells. No deeper invasion was Mentified. Based on the histological findings, a diagnosis of nephrngenic adenoma was established. Immunohistochemically, the tumor was positive for P504S but negative for 1363, a pattern similar to the prostate cancer. Fortunately, expression of 34βE12 （high molecular cytokeratin） and absence of PSA favored the diagnosis of nephrogenic adenoma. Ki-67 index was around 10%. Conclusion Nephrogenic adenoma is a rare and easily misdiagnosed lesion. Knowing well the histological feature remains the key to the correct diagnosis.

关 键 词：肾源性腺瘤 膀胱 免疫组化 

分 类 号：R737.14[医药卫生—肿瘤]