Hussein Mahmoud-Rezk A, Al-Assiri Mana, Eid Refaat A, Musalam Adel O
Assir Central Hospital, Abha, Saudi Arabia.
Ultrastruct Pathol. 2010 Aug;34(4):232-5. doi: 10.3109/01913121003743708.
Small cell neuroendocrine carcinoma (SCNEC) of the urinary bladder is a rare but aggressive neoplasm that usually exhibits neuroendocrine differentiation. Here, the authors report a case of SCNEC in an 80-year-old man. The patient had gross hematuria and nodular mass involving the wall of the urinary bladder. Total cystectomy was done. The tumor consisted of small, uniform, round, and spindled-shaped cells with chromatin dark nuclei and numerous mitotic figures. The cells were reactive for chromogranin, neuron-specific enolase (diffuse), and keratin (focal). Ultrastructural studies revealed neurosecretory granules and intermediate filaments. The diagnosis of SCNEC with focal high-grade urothelial component was established. No metastasis was found at the time of diagnosis and the patient refused further chemotherapy or radiotherapy. The histogenesis, differential diagnosis, and prognosis of SCNEC of the urinary bladder were discussed.
膀胱小细胞神经内分泌癌（SCNEC）是一种罕见但侵袭性强的肿瘤，通常表现为神经内分泌分化。在此，作者报告一例80岁男性的SCNEC病例。患者有肉眼血尿和累及膀胱壁的结节状肿块。行膀胱全切术。肿瘤由小的、形态一致的圆形和梭形细胞组成，细胞核染色质深，有许多有丝分裂象。这些细胞对嗜铬粒蛋白、神经元特异性烯醇化酶（弥漫性）和细胞角蛋白（局灶性）呈阳性反应。超微结构研究显示有神经分泌颗粒和中间丝。确诊为伴有局灶性高级别尿路上皮成分的SCNEC。诊断时未发现转移，患者拒绝进一步化疗或放疗。本文讨论了膀胱SCNEC的组织发生、鉴别诊断及预后。
