膀胱相关性假肉瘤性肌纤维母细胞增生1例报告并文献复习  

作　　者：于管天[1] 廖松柏[1] 于永刚[1] 武英杰[1] 刘为池[1] 

机构地区：[1]解放军181医院泌尿外科,广西桂林541002

出　　处：《湖南中医药大学学报》2016年第A02期1230-1230,共1页Journal of Hunan University of Chinese Medicine

摘　　要：目的 提高对膀胱相关性假肉瘤性肌纤维母细胞增生的诊治水平.方法 回顾性分析1例膀胱相关性假肉瘤性肌纤维母细胞增生患者的临床资料.患者,男,21岁,因“反复排出鲜红色尿液伴大量血块3天”于2014年04月21日入院.彩超及CT 提示膀胱前壁实性占位性病变.因血尿严重,导尿管反复堵塞,行膀胱镜检查见膀胱前壁一大小约4×5cm 实性带蒂占位.考虑可微创手术,遂于入院当日急诊在硬膜外麻醉下行经尿道膀胱占位2um 激光切除术.术中行快速病理检查,提示为炎性假瘤.遂结束手术.结果 术后我院病理报告：炎性假瘤梭形细胞浸润至平滑肌层,肿物底部见梭形细胞浸润.免疫组化CK（部分＋）、VIM（＋）、CK7（＋）、S100（-）、SMA（-）、Desmin（-）、CD34（血管＋）、CD68（＋）、P63（-）、Ki67（＋20%）.广西医科大学附属肿瘤医院会诊报告：光镜检查：粘液水肿背景下梭形细胞增生,排列舒松,无规则,细胞核卵圆形,大部分可见核仁,有些如神经节细胞样,核分裂像可见,但无病理性核分裂像;间质含丰富肉芽肿型毛细血管,伴中性粒为主的炎性浸润和红细胞外渗.免疫表型：Vimentin（＋）、ALK（＋）、Calponin（＋）、myogenin（NS）、Actin（＋,弱）、Desmin（-）、S100（-）.病理诊断为：膀胱相关性假肉瘤性肌纤维母细胞增生.随访2年未见肿瘤复发.结论 膀胱相关性假肉瘤性肌纤维母细胞增生罕见,临床症状及影像学检查诊断困难,确诊依靠需病理学检查.治疗可选择微创手术.objective to improve the false correlation with bladder sarcoma muscle fiber mother cell hyperplasia of the diagnosis and treatment level. Methods a retrospective analysis of 1 case of bladder correlation false sex muscle fiber mother cell sarcoma hyperplasia in patients with clinical data. Patients, male, 21 years old, because of “repeated” bright red urine with a large number of blood clots from 3 days in April 21, 2014, admitted to hospital. With a solid colour to exceed and CT reminders before the bladder wall space-occupying lesions. The severe hematuria, catheter blockage, repeatedly line cystoscopy see bladder wall before a size about 4 ×5cm solid pedicle placeholders. Consider to minimally invasive surgery, hence on the hospitalized day emergency transurethral plasmakentic vaporization of bladder under epidural anesthesia placeholder 2 um laser resection. The bank of China fast pathologic examination, tips for inflammatory pseudotumor. With one end of the operation. Results postoperative hospital pathology report： inflammatory pseudotumor spindle cells infiltrating through smooth muscle layer, the mass see at the bottom of the spindle cells infiltration. Immunohistochemical CK （＋）, VIM （＋） and CK7 （＋）, according to （-）, SMA （-）, Desmin （-） and CD34 ＋ （blood vessels）, CD68 （＋）, about （-） and Ki67 （＋ 20%）. Guangxi medical university affiliated tumor hospital consultation report microscopical examination： under the background of myxedema spindle cell hyperplasia, arrange ShuSong, no rules, the nuclei are ovoid, most visible nucleoli, some, such as ganglion cells, nuclear fission as can be seen, but without pathological fission like; Interstitial rich granuloma type capillary, with neutral grain of inflammatory infiltrates and extravasation of red blood cells. The immune phenotype, Vimentin （＋）, ALK （＋）, Calponin （＋）, myogenin （NS）, Actin （＋, weak）, Desmin （-）, according to （-）. The pathological

关 键 词：膀胱相关性假肉瘤性肌纤维母细胞增生(PMP) 炎性假瘤 炎性肌纤维母细胞瘤 诊断 治疗 

分 类 号：R2[医药卫生—中医学]