膀胱低度恶性潜能乳头状尿路上皮肿瘤12例临床病理分析

Report of 12 Cases of Papillary Urothelial Neoplasm of Low Malignant Potential of the Urinary Bladder with Clinicopathological Analysis and Review of the Literature

  • 摘要: 目的:结合文献复习探讨膀胱低度恶性潜能乳头状尿路上皮肿瘤(PUNLMP)临床病理学、免疫组化、鉴别诊断及预后。方法:对12例进行经尿道膀胱电切术(TURBt),经病理制片,光镜观察及免疫组化CK20、Ki-67、34!E12标记。结果:12例患者平均年龄为53.3岁,临床症状以血尿为主,膀胱镜检查病损均为<3cm。光镜观察均符合PUNLMP的诊断标准。预后10例获随访12~36月不等,均无复发。结论:膀胱PUNLMP属介于良、恶性之间肿瘤的独立类型,需长期随访,偶有复发,大多数病例不进展为癌,应与低级别癌区分。

     

    Abstract: Objective: To explore the clinicopathological and immunohistochemical features, differential diagnosis, and prognosis of papillary urothelial neoplasm of lowmalignant potential (PUNLMP), and to reviewthe literature. Methods: Transurethral resection of bladder tumor (TURBT) was performed on all 12 cases of PUNLMP, and pathological sections were made. Microscopic and immunohistochemical evaluations were performed. Results: The average age of the 12 patients was 53.3 years. Hematuria was the chief symptom. The diameters of all lesions were less than 3 cm based on findings with a cystoscope. The features on microscopy were all consistent with the diagnostic criteria of PUNLMP. Follow-ups were obtained for 10 patients, and the durations ranged from 12 to 36 months. No recurrence was found. Conclusion: PUNLMP in the urinary bladder is a distinct type of intermediate tumor with behavior somewhere between benign and malignant tumors that needs a long period of follow-up. Recurrence is rare. Most cases do not progress into carcinoma. PUNLMP should be differentiated from the lowgrade carcinomas as a separate entity.

     

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