肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎一例并文献复习

Renal replacement lipomatosis associated with xanthogranulomatous cystitis: a case report and review of the literature

目的探讨罕见的肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎病例的发病机制、病理特点、临床表现、诊断和治疗。方法回顾性分析1例我院收治的肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎病例临床资料,复习相关文献并予以讨论。患者女,51岁,因"无痛性肉眼血尿6个月"入院,术前拟诊为左肾盂癌伴输尿管膀胱种植转移。结果先后行膀胱镜检+活检术、经尿道膀胱肿物切除术、3D腹腔镜下左肾切除+左输尿管切除术,术中术后病理结果:左肾盂脂肪瘤病合并膀胱黄色肉芽肿性膀胱炎,术后随访6个月未见异常。结论肾盂脂肪瘤病和膀胱黄色肉芽肿性膀胱炎均为临床上罕见的良性疾病,同一患者同时合并有这两种疾病的病例暂未见报道。该病需与泌尿系统的其他良恶性肿瘤相鉴别,以便正确诊断与及时治疗。

Objective To review the pathogenesis, pathology, clinical manifestations, diagnosis and differential diagnosis and treatment of a rare case of renal replacement lipomatosis（RRL） complicated with xanthogranulomatous cystitis（XC）. Methods A 51-year-old female patient was admitted to the hospital with macroscopic hematuria for 6 months. Combined with preoperative imaging examination, preoperative diagnosis was left renal pelvis cancer with ureteral bladder implant metastasis. The case of RRL complicated with XC was analyzed and reviewed the literatures. Results The patient has received cystoscope detect and mucosa Biopsy, TURBT, 3D laparoscopic left nephrectomy and left ureterectomy. The pathological results were RRL complicated with XC. The patient was free of signs of recurrence 6 months after operation. Conclusions Both RRL and XC are rare benign diseases. No case of the same patient with both diseases have been reported. The disease needs to be differentiated from other benign and malignant tumors of the urinary system for proper diagnosis and timely treatment.