Sakamoto N, Tsuneyoshi M, Enjoji M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Histopathology. 1992 Aug;21(2):135-41. doi: 10.1111/j.1365-2559.1992.tb00361.x.
A mapping study of cystectomy specimens in three cases of pure squamous cell carcinoma and 28 cases with transitional cell carcinoma with squamous differentiation is described, with an emphasis on the histogenesis of pure squamous cell carcinoma. Two of the three cases of pure squamous cell carcinoma had extensive benign keratinizing mucosa and an atypical squamous metaplastic mucosa contiguous with the tumour. These pure squamous cell carcinomas seemed to be derived from the squamous metaplasia. On the other hand, in all except one of the cases of transitional cell carcinoma with squamous differentiation, there was neither benign keratinizing nor atypical squamous metaplastic mucosa in the bladder. The quantitative amounts of both the transitional cell and squamous components differed from case to case in 28 cases with transitional cell carcinoma with squamous differentiation. Five of the 28 had a tumour composed predominantly of a squamous component with minute transitional cell components at the margin. In another two cases, transitional carcinoma in situ or satellite tumours of transitional cells were present adjacent to the main tumour which was composed of squamous cell carcinoma alone. We think these seven tumours originated as a result of extensive squamous differentiation in the transitional cell carcinomas. These features may indicate two forms of histogenesis of pure squamous cell carcinoma. The first is malignant transformation on the basis of squamous metaplasia of the bladder mucosa and the second is extensive squamous differentiation in a pre-existing transitional cell carcinoma.
本文描述了对3例纯鳞状细胞癌和28例伴有鳞状分化的移行细胞癌膀胱切除标本的映射研究，重点是纯鳞状细胞癌的组织发生。3例纯鳞状细胞癌中有2例有广泛的良性角化黏膜以及与肿瘤相邻的非典型鳞状化生黏膜。这些纯鳞状细胞癌似乎起源于鳞状化生。另一方面，除1例伴有鳞状分化的移行细胞癌外，其余病例的膀胱中均无良性角化或非典型鳞状化生黏膜。28例伴有鳞状分化的移行细胞癌中，移行细胞和鳞状成分的数量在不同病例中各不相同。28例中有5例肿瘤主要由鳞状成分组成，边缘有微小的移行细胞成分。另外2例中，在仅由鳞状细胞癌组成的主要肿瘤附近存在原位移行癌或移行细胞卫星肿瘤。我们认为这7个肿瘤是移行细胞癌广泛鳞状分化的结果。这些特征可能表明纯鳞状细胞癌的两种组织发生形式。第一种是基于膀胱黏膜鳞状化生的恶性转化，第二种是在先前存在的移行细胞癌中广泛的鳞状分化。
