膀胱炎性肌纤维母细胞瘤的临床病理分析  

Clinicopathologic Analysis of Inflammatory Myofibroblastic Tumor of the Urinary Bladder

作　　者：刁磊[1] 魏海霞[2] 田洁[1] 娄越亮[1] 

机构地区：[1]天津医科大学附属肿瘤医院泌尿肿瘤科 天津市肿瘤防治重点实验室,天津市300060 [2]天津市南开区王顶堤医院妇产科

出　　处：《中国肿瘤临床》2011年第22期1400-1402,1407,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨膀胱炎性肌纤维母细胞瘤的临床、病理和诊治方法及预后。方法:对2例膀胱炎性肌纤维母细胞瘤患者的临床资料、病理形态学和免疫组织化学染色进行观察;对2例患者进行随访观察。结果:病例1行膀胱部分切除术,病例2行全膀胱切除+盆腔淋巴结清扫术。组织学表现均为增生的梭形或长梭形肿瘤细胞囊状分布,间质小血管增生,伴淋巴细胞、嗜酸性粒细胞及浆细胞浸润。免疫组织化学染色结果:病例1为SMA(+),Vimentin(+),ALK(+)。病例2为SMA(+),CD68(+),Vimentin(+),CgA(+),ALK(-)。2例病例均不表达CK7、S-100、MyoDl、CK19、α-actin、EMA。2例患者均未见复发。结论:膀胱炎性肌纤维母细胞瘤是一种少见肿瘤,确诊主要依据组织病理学检查及免疫组织化学染色,应与横纹肌肉瘤、梭形细胞癌等鉴别,治疗以膀胱部分切除或经尿道切除为主。Objective： To review the clinicopathologic features of inflammatory myofibroblastic tumor of the urinary bladder （IMTUB） and to discuss its diagnosis, treatment, and prognosis. Methods： The clinical data, light microscopy, and immunohistochemical results of two IMTUB cases were analyzed. Follow-up of the two patients was also conducted. Results： Partial cystectomy was per- formed on Case I. Total cystectomy plus pelvic lymphadenectomy was conducted on Case II. The post-operative pathological examination indicated that the sections exhibited spindle neoplastic cells and capillary proliferation, accompanied by infiltration of lympho- cytes, eosinophil cells, and plasma cells. Immunohistochemical staining of the Case I revealed smooth muscle actin （ SMA ） （ ＋ ）, Vi- mentin （ ＋ ）, and anaplastic lymphoma kinase （ ＋ ）. Immunohistochemical staining of the CaseⅡ showed SMA （ ＋ ）, CD68 （ ＋ ）, Vi- mentin （ ＋ ）, chromogranin A （ ＋ ）, and anaplastic lymphoma kinase （-）. Tumor cells were negative for CK7, S-100, MyoD1, CK19, Actin, and EMA. Signs of recurrence were not found in the two cases. Conclusion： IMTUB is a rare tumor. Final diagnosis of the tumor depends mainly on histopathological examination and immunohistochemical staining. IMTUB should be differentiated from rhabdo- myosarcoma and other spindle-cell carcinomas. Partial cystectomy or transurethral resection is the main choice of treatment.

关 键 词：炎性肌纤维母细胞瘤 膀胱 诊断 治疗 

分 类 号：R737.14[医药卫生—肿瘤]