膀胱副神经节瘤二例报告并文献复习  

Paraganglioma of urinary bladder （two cases reports and review of literatures）

作　　者：范敏[1] 何小舟[1] 许贤林[1] 徐仁芳[1] 巢志复[1] 夏炜[1] 陈铜兵[2] 严春寅[3] 

机构地区：[1]苏州大学附属第三医院,常州市第一人民医院泌尿外科,213003 [2]苏州大学附属第三医院,常州市第一人民医院病理科,213003 [3]苏州大学附属第一医院泌尿外科

出　　处：《中华泌尿外科杂志》2011年第3期199-202,共4页Chinese Journal of Urology

摘　　要：目的总结膀胱副神经节瘤的临床病理学特征及诊疗方法。方法膀胱副神经节瘤2例。例1，女，35岁。临床表现排尿后心慌、头痛，B超及CT检查示膀胱左侧壁肿块2．6cm×1．5cm，尿3-甲氧4羟苦杏仁酸（VMA）35．3～43．3μmol／24h（正常值10～35μmol／24h）。例2，男，22岁。临床表现无痛性全程血尿，B超及CT检查示膀胱右前壁肿块2．5cm×2．0cm，尿VMA17．9～31．3μmol／24h。结果行经尿道膀胱肿瘤电切术1例，行膀胱部分切除术1例。病理诊断为膀胱副神经节瘤。免疫组化CgA、Syn、S-100蛋白和NSE（＋）。患者术后症状消失，行膀胱镜及B超分别随访3个月、3年肿瘤无复发。结论膀胱副神经节瘤为潜在恶性肿瘤，诊断需结合临床、病理及免疫组化结果判断，膀胱部分切除为主要治疗手段。Objective To study the clinical,histopathological,immunohistochemical features and the diagnosis and treatment of paraganglioma of urinary bladder. Methods Two cases of paragangli oma of urinary bladder were treated. The first case was a male with painless haematuria. The abdomi nal ultrasonography and CT scan showed a 2.5 cm×2.0 cm mass in the right anterior wall of the blad der, and urine vanillylmandelic acid elevated to 17. 9 -- 31. 3μmol/24 h （normal range 10 -- 35 μmol/24 h）. The second case was a female who presented with 8 years history of headache and palpi ration after voiding. Abdominal ultrasonography and CT scan showed a 2.6 cm× 1.5 cm mass in the left wall of the bladder, and her urine vanillylmandelie acid was 35.3--43.3μmol/24 h. Results One patient underwent transurethral resection （TURBT） and the other underwent partial eystectomy. The two cases were diagnosed as bladder paraganglioma by pathological examination. Immunohisto chemically,the tumor cells were positive for CgA, Syn, NSE and S-100. No evidence of recurrence was detected during follow-up at 3 months and 3 years. Conclusions Paraganglioma of urinary blad der should be considered as a low grade malignancy. Partial cystectomy should be recommended. The diagnosis depends on clinical symptoms, pathological and immunohistochemical results.

关 键 词：膀胱肿瘤 副神经节瘤 病理学 临床 

分 类 号：R737.14[医药卫生—肿瘤]