泌尿道肾源性化生6例临床病理分析  

Clinicopathologic features of nephreogenic metaplasia in urologic tract: a report of 6 cases

作　　者：欧阳琪[1] 肖立[1] 陈燕[1] 卢晨[1] 余波[1] 衣琳[1] 殷于磊[1] 

机构地区：[1]复旦大学附属华东医院病理科,上海200040

出　　处：《临床与实验病理学杂志》2016年第12期1353-1356,1360,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的 探讨肾源性化生（nephrogenic metaplasia,NM）的临床病理学特征、免疫表型及鉴别诊断。方法 回顾性分析6例泌尿道NM,分析其临床资料、病理学形态和免疫表型特征,并复习相关文献。结果 女性1例,男性5例;年龄31-81岁,平均58.1岁;2例有泌尿道结石、3例有前列腺增生症或腺性膀胱炎而经尿道电切病史、1例同时伴发尿路上皮癌;3例累及输尿管、2例前列腺尿道部、1例膀胱三角区。膀胱镜下见黏膜粗糙或低乳头状突起。镜下见病变主要由管状、囊状、小巢状和乳头状结构组成,可见伊红色基膜样物;增生上皮为立方状或柱状,部分有细胞学非典型性;间质慢性炎。免疫表型：表达PAX2、PAX8、CK7、P504S,不表达p63、CD10、PSA。结论 NM是少见的尿路上皮瘤样病变,常有泌尿道损伤病史,需与尿路上皮癌、前列腺癌、透明细胞腺癌及子宫内膜异位鉴别,掌握其临床病理学和免疫表型特征可提高确诊率。Purpose To investigate the clinicopathologic and immunohistochemical features, and differential diagnosis of nephrogenic metaplasia （NM）. Methods The clinical data, histological and immunohistochemical characteristics of 6 cases of NM were analyzed, with review of the literature. Results There were 1 case of female, 5 cases of male, aged from 31 to 81 years, with average of 58. 1 years. The history revealed lithiasis of urologic tact in 2 cases, previous transurethral resection for benign prostatic hyperplasia or cystitis glandularis in 3 cases, and concurrent urothelial carcinoma in 1 case. The lesion involved in the ureter in 3 cases, prostatic urethra in 2 cases, and bladder trigone in 1 case. Cystoseopic examination demonstrated mucosal rough or low villous protrude. Microscopically, the lesion was consisted of tubules, cysts, small nests and papillary structures with basement membrane-like eosinophilic sheath, and lined by cuboidal, or low column epithelial cells with cytological atypia in some area, and shown inflammation in stroma. Immunohistochemically, there was positive staining for PAX2, PAX8, CK7 and P504S, negative for p63, CD10, and PSA. Conclusion NM is a rare tumor-like lesion often with injure of urologic tract, and should be differential with urothelial carcinoma, prostatic carcinoma, clear cell adenocarcinoma and endometriosis. It＇ s important to know the clinicopathological and immunohistochemical features of NM for the correct interpretation.

关 键 词：肾源性化生 尿路上皮 诊断 鉴别 免疫表型 

分 类 号：R737[医药卫生—肿瘤]