膀胱平滑肌瘤的临床病理学观察

Clinicopathological features of bladder leiomyoma

目的探讨膀胱平滑肌瘤的临床病理学特征。方法回顾性分析2006—2022年苏州大学附属第三医院手术切除的13例膀胱平滑肌瘤患者资料,观察组织病理学特征及免疫表型,并复习文献。结果女性12例,男性1例,均为良性,术后无复发。肿瘤组织呈束状或编织状排列,男性瘤体可见梗死灶。肿瘤细胞无异型性,免疫组化表达SMA、Desmin、Caldesmon。发生在膀胱三角区的7例中,6例女性ER强阳性/阳性,1例男性ER阴性。在不合并子宫平滑肌瘤的7例患者中,6例ER强阳性/阳性。结论膀胱平滑肌瘤好发于女性,预后良好,部分合并子宫平滑肌瘤。ER高表达可见于绝经后女性的膀胱平滑肌瘤,尤其是膀胱三角区患者,但此标记可能无法明确区分瘤体是否源自子宫。

Objective To investigate the clinicopathological features of bladder leiomyoma.Methods A retrospective analysis of the clinical data,histopathology and immunophenotype were analyzed on 13 patients diagnosed with bladder leiomyoma admitted to the Third Afiliated Hospital of Sochow University from February 2006 to July 2022,and literatures were reviewed.Results Twelve cases were female patients,and 1 case was the male patient.All cases were all benign and had no recurrence after surgery.Tumor tissue were arranged in bundles and braided.Areas of infarction were seen in bladder leiomyoma of male patient.Tumor cells had no atypia and immunohistochemistry showed that they expressed SMA,Desmin and Caldesmon.In 7 cases of bladder leiomyoma occurred in the bladder triangle area,there were 6 females that tumor cells were strongly positive or positive for ER,and the remaining 1 male of tumor cells were negative for ER.In 7 cases of patients not complicated with uterine leiomyoma,there were 6 patients that tumor cells were strongly positive or positive for ER.Conclusion Bladder leiomyoma affect female patients more than male patients and have favorable prognosis.A small number of patients may be complicated with uterine leiomyoma.Higher levels of ER expression may be seen in bladder leiomyoma of postmenopausal females,especially occurred in the bladder triangle area,and this marker cannot definitively distinguish whether or not the bladder leiomyoma originated from the uterus.