Perez-Montiel Delia, Hes Ondrej, Michal Michal, Suster Saul
Department of Pathology, Ohio State University Medical Center, Columbus, USA.
Am J Clin Pathol. 2006 Jul;126(1):86-92. doi: 10.1309/K7ME-LVFP-KQE2-RCDL.
We report 5 cases of micropapillary urothelial carcinoma (MPUC) involving the renal pelvis (2), renal pelvis and ureter (2), and proximal ureter (1). The patients were 2 women and 3 men, ages 65 to 92 years (mean, 76.0 years). All tumors showed a high-grade transitional cell carcinoma component, and in 3 cases, there also were areas of in situ carcinoma. The case involving only the ureter occurred in a 65-year-old man with a history of nephrectomy 12 years previously for urothelial carcinoma of the renal pelvis. The tumor recurred in the ureteral stump. In all cases, areas displaying micropapillary architecture were observed. In 2 cases the micropapillary areas were noninvasive; in 1 case a pure invasive pattern was seen; and in 2 cases a mixed invasive and noninvasive pattern was present. the micropapillary pattern was invasive; and the case involving the ureteral stump contained invasive and noninvasive micropapillary carcinoma. All patients died of their tumors from 3 to 24 months after initial diagnosis. MPUC involving the renal pelvis and ureter is associated closely with advanced stages of disease and has highly aggressive behavior. Recognition of this growth pattern is important for prognosis and avoiding misdiagnosis with papillary renal cell carcinoma and other tumors.
我们报告了5例微乳头型尿路上皮癌（MPUC），其中2例累及肾盂，2例累及肾盂和输尿管，1例累及输尿管近端。患者包括2名女性和3名男性，年龄在65至92岁之间（平均76.0岁）。所有肿瘤均显示高级别移行细胞癌成分，3例还存在原位癌区域。仅累及输尿管的病例发生在一名65岁男性，12年前因肾盂尿路上皮癌行肾切除术。肿瘤在输尿管残端复发。所有病例均观察到呈现微乳头结构的区域。2例微乳头区域为非浸润性；1例为单纯浸润性模式；2例为浸润性和非浸润性混合模式。微乳头模式具有浸润性；累及输尿管残端的病例包含浸润性和非浸润性微乳头癌。所有患者在初次诊断后3至24个月死于肿瘤。累及肾盂和输尿管的MPUC与疾病晚期密切相关，具有高度侵袭性。认识这种生长模式对于预后以及避免与乳头状肾细胞癌和其他肿瘤的误诊很重要。
