膀胱肾源性腺瘤八例报告并文献复习

The nephrogenic adenoma of the bladder:8 cases and literature review

目的:分析8例膀胱肾源性腺瘤的临床特点,以提高对该病的认知和诊疗水平。方法:回顾性分析2016年7月至2019年6月中山大学孙逸仙纪念医院收治的8例膀胱肾源性腺瘤患者的临床和病理资料。男5例,女3例。年龄55(33~71)岁。临床表现为血尿7例,尿路刺激征6例,无明显症状1例。合并疾病:7例膀胱炎,3例尿石症,2例膀胱癌,1例侵袭性结肠肠系膜纤维瘤,1例无其他合并疾病。5例有泌尿系手术史。5例发生于侧壁;5例单发;肿物平均直径为0.9(0.1~1.8)cm。膀胱镜下可见乳头状肿物,表面呈鲜红色,蒂不明显,乳头粗短,触之易出血;部分呈散在片状苔藓样改变。8例均接受经尿道膀胱病变黏膜电切术。结果:8例术后病理检查:镜下见膀胱黏膜组织呈慢性炎,间质水肿,肉芽组织增生,嗜酸性粒细胞浸润,上皮呈中肾样化生。8例均获得电话随访,平均随访时间17.1(2~38)个月,均未出现复发。结论:膀胱肾源性腺瘤确诊依靠病理检查,术中应切除完全,术后应密切观察,及时处理复发和恶变。

Objective To analyze the clinical characteristics of nephrogenic adenoma of the bladder.Methods The clinical and pathological data of 8 patients with bladder nephrogenic adenoma,during the period from July 2016 to June 2019,were retrospectively analyzed.Patients’age were 33 to 71 years old and the average age was 55,including 5 males and 3 females.The clinical manifestations were hematuria in 7 cases,urinary tract irritation in 6 cases,and no obvious symptoms in 1 case.There were 7 cases with cystitis,3 cases with urolithiasis,2 cases with bladder cancer,1 case with invasive colonic mesentery fibroma,and 1 case without other complications.5 cases had the history of urological operation.The predilection site was the lateral wall with 5cases;5 cases were solitary;the average maximum diameter of the tumor was 0.9 cm(range 0.1-1.8 cm).Under cystoscope,papillary mass can be seen,the surface is bright red,the pedicle is not obvious,the papilla is thick and short,easy to bleed when touching;some of them are scattered and lichen like changes.All patients received transurethral resection of bladder mucosa.Results Pathological examination shows that the bladder mucosa showed chronic inflammation,interstitial edema,granulation tissue hyperplasia,eosinophil infiltration and metaplasia of mesonephroid epithelium.All of the 8 patients were followed up by telephone for 2 to 38 months,with an average of 17.1 months.So far,neither recurrence has been detected.Conclusions The diagnosis of nephrogenic adenoma of the bladder depends on pathological examination.It must be totally removed during operation.The recurrence and malignancy should be treated in time after operation.