Medeiros L J, Young R H
James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Boston 02114.
Arch Pathol Lab Med. 1989 Feb;113(2):125-8.
Five cases of nephrogenic adenoma that arose within urethral diverticula are described. Four of the five women were under 40 years of age and one was 56 years old. Three presented to their gynecologists because of a "vaginal mass." Microscopic examination showed the typical tubular, cystic, and papillary patterns of nephrogenic adenoma. "Hobnail" cells were present in four cases and clear cells in two. The absence of four features, deep invasion, a prominent diffuse growth of glycogen-rich clear cells, significant nuclear atypia, and mitotic activity, argued against the diagnosis of clear-cell adenocarcinoma, which has a predilection to occur within urethral diverticula. Alertness to the possible presence of nephrogenic adenoma within a urethral diverticulum in a patient with predominantly gynecologic symptoms and knowledge of its morphologic variations is essential to prevent its misdiagnosis as clear-cell adenocarcinoma.
本文描述了5例发生于尿道憩室内的肾源性腺瘤病例。5名女性患者中，4名年龄在40岁以下，1名56岁。3例因“阴道肿物”就诊于妇科医生。显微镜检查显示出肾源性腺瘤典型的管状、囊性和乳头状结构。4例可见“鞋钉样”细胞，2例可见透明细胞。缺乏深部浸润、富含糖原的透明细胞显著弥漫性生长、明显的核异型性和有丝分裂活性这四个特征，不支持诊断为透明细胞腺癌，透明细胞腺癌好发于尿道憩室内。对于以妇科症状为主的患者，警惕尿道憩室内可能存在肾源性腺瘤，并了解其形态学变异，对于防止将其误诊为透明细胞腺癌至关重要。
