膀胱炎性肌纤维母细胞瘤复发并转移临床病理分析  

Clinicopathological features of inflammatory myofibroblastc tumor of urinary bladder

作　　者：王志强[1] 周先明[2] 宋文灿[3] 赵志光[4] 

机构地区：[1]池州市人民医院病理科,安徽池州247000 [2]池州市人民医院泌尿外科,安徽池州247000 [3]池州市人民医院肿瘤科,安徽池州247000 [4]温州医学院附属第二医院病理科,浙江温州325000

出　　处：《实用肿瘤杂志》2013年第5期513-516,共4页Journal of Practical Oncology

摘　　要：目的探讨膀胱炎性肌纤维母细胞瘤临床病理特点、诊断治疗及预后相关因素。方法观察1例膀胱炎性肌纤维母细胞瘤并随访5年,结合文献进行分析。结果患者为男性,60岁,临床表现为无痛性血尿伴尿频、尿痛。影像学发现膀胱顶底部肿块4.7 cm×3.9 cm,行膀胱部分切除术,组织学见黏液背景的细胞稀疏区和束状排列的梭形细胞密集区,伴浆细胞及淋巴细胞浸润,坏死多见。免疫组织化学检测瘤细胞Vimentin、CK、Hcaldesmon和SMA阳性,Desmin、S-100、EMA、ALK-1、CD34、Bcl-2、CD99阴性。术后3年膀胱肿瘤复发经尿道切除,组织学见神经节样细胞。术后5年患者出现肺、脑、骨、脾、肌组织和皮下软组织转移,3月后患者呼吸衰竭死亡。结论膀胱炎性肌纤维母细胞瘤恶性转化为一老年男性、ALK阴性患者。一旦发生转移患者处于进展高级别状态,预后差。Objective To investigate the clinical and pathological characteristics, the treatment and prognosis of inflammatory myofibrnblastie tumor （IMT） of the urinary bladder. Methods The clinical data of one case of IMT of the urinary bladder were reported and the relevant literature was reviewed. Results A 60-year-old man was referred for painless hematuria with frequent urination and odynuria. Computed tomography revealed a oval nodular mass on the top and bottom of the bladder. The patient underwent partial eystectomy. Histology revealed a proliferation of spindle cells with inflammation. Tumor cells expressed Vimentin, CK, H- ealdesmon and SMA,but Desmin, S-100, EMA, ALK-1, CD34, Bel-2, CD99 were negative. The tumor recurred 3 years later and the patient undertook transurethral resection,histology revealed ganglion-like cells. Five years later, the patient was found multiple organ, soft tissue metastasis and died of respiratory failure 3 montbes later. Conclusions This was an old male patient of IMT of the urinary bladder exhibiting malignant transformation with ALK negative. Once tumor metastasizes,the patients are in the progress of high-grade state with poor prognosis.

关 键 词：肿瘤 肌组织 膀胱 肿瘤转移 预后 免疫组织化学 

分 类 号：R737.14[医药卫生—肿瘤]