膀胱尿路上皮癌伴发前列腺腺癌临床病理分析

A Clinicopathologic Analysis of Papillary Urothelial Carcinoma Associated with Prostate Adenocarcinoma

目的探讨膀胱尿路上皮癌伴发前列腺腺癌的临床及病理学特点。方法对8例膀胱尿路上皮癌伴发前列腺腺癌的病理切片做常规及免疫组织化学染色,并对其临床和病理学特征进行回顾性分析。结果本组患者发病年龄55～79岁,平均年龄69.3岁。8例均有肉眼血尿,呈间歇性发作。5例有尿频、尿急、尿不尽情况,3例有进行性排尿困难。镜下见膀胱尿路上皮癌呈乳头状结构,可见乳头融合及多少不等的实性癌巢结构;前列腺腺癌由大小不等、形状不规则的腺体构成,腺上皮细胞可见核仁及核分裂象。结论 膀胱尿路上皮癌伴发前列腺腺癌是一种比较少见的多发性原发癌,极易漏诊。当首诊为前列腺腺癌或膀胱癌时应考虑到两者合并存在的可能性,以获得更好的治疗效果。

Objective To investigate the clinical and pathological characteristics of papillary urothelial carcinoma associated with prostate adenocarcinoma. Methods Hematoxylin - eosin and immunohistochemical staining were used in 8 cases of papillary urothelial carcinoma associated with prostate adenocarcinoma. The clinical and pathological features were studied by retrospective analysis. Results The incidence age of the patients were 55 -79 years old, average 69.3 years old. All the patients had gross hematuria, which happened intermittently. Five patients suffered from frequent micturition, urgency of urination, urinary endless and 3 patients suffered from progres- sive dysuria. Papillary structures could be observed in papillary urothelial carcinoma under a microscope： some papillary structures clustered and solid nest cancer structure conformed. Prostate adenocarcinoma was composed by different sized and irregular shaped glands, and nucle- oli and mitotic figures were seen in glandular epithelium cells. Conclusion Papillary urothelial carcinoma associated with prostate adeno- carcinoma is a kind of multiple primary cancer rarely happened, which could be missed easily. Once the first diagnosis of prostate cancer or bladder cancer is made, the possibility of both two diseases existing should be taken into account, which will bring a better treatment effect.