膀胱小细胞神经内分泌癌4例报道并文献复习

Small cell carcinoma of urinary bladder:report of 4 cases and review of literature

目的 研究膀胱小细胞神经内分泌癌的临床病理特征和生物学行为。方法 采用光镜、免疫组化对 4例膀胱小细胞神经内分泌癌进行观察并随访。结果 本组患者平均年龄 6 6 3岁 ,首发症状均为间断性无痛性全程肉眼血尿 ,2例患者 6～ 7个月死于肿瘤复发和 /或转移 ,1例 3个月已有肝转移。所有切除肿瘤的组织学形态与肺小细胞癌相似。 4例患者中只有 1例术前得到明确病理诊断。肿瘤细胞均表达神经内分泌标记物NSE、CgA和Syn ,仅 1例肿瘤细胞CK呈弱阳性表达。结论 膀胱小细胞神经内分泌癌是一种比较少见的高度恶性肿瘤 ,有独特的病理形态 ,早期即可发生转移 ,预后凶险 ,活检容易漏诊。

Objective To study the clinical, histological, and immunohistochemical characteristics of small cell neuroendocrine carcinoma (SCC) of the urinary bladder and its behaviour. Methods Four cases of SCC in urinary bladder were investigated by light microscopy and immunohistochemical staining. Clinical follow up was collected. Results The average age in this group of patients were 66.3. The onset symptom was discontinuous, and whole course hemuresis with naked-eye. Two patients died of recurrence and metastasis of carcinoma after follow-up for six or seven months. One patient had metastatic carcinoma in the liver after three months. the Histological type of all the in cised cancer was similar to small cell carcinoma of the lung. Pathologic diagnosis in one case was confirmed before operation. The neuroendocrinic markers, such as NSE, CgA, and Syn, were expressed in all the tumor cells, excepting that CK was weakly positive in one case. Conclusion SCC of the urinary bladder is rare and highly malignant tumor with distinct pathological features. It is aggressive with early metastases and has a poor prognosis. It was often misdiagnosed by bispsy