Kailavasan Mithun, Ellis Ricky, O'Dowd Sophie, Sherwood Benedict, Bazo Alvaro
Department of Urology, Nottingham City Hospital, Hucknall Road, Nottingham, UK.
Department of Radiology, Nottingham City Hospital, Hucknall Road, Nottingham, UK.
J Surg Case Rep. 2018 Aug 6;2018(8):rjy193. doi: 10.1093/jscr/rjy193. eCollection 2018 Aug.
Intestinal metaplasia (IM) of the bladder is an extremely rare benign condition. The clinical features are similar to other bladder tumours. Its pathogenesis is unclear and its role as a precursor of adenocarcinoma has long been debated. Transurethral resection is the main form of treatment for IM. We report the case of a 49-year-old gentleman who presented with visible haematuria. He was submitted to multiple cystoscopies which showed no macroscopic irregularities. Radiological (CT urogram and multiparametric MRI) imaging revealed abnormalities within the bladder neck, suspicious of a neoplastic lesion. Following transurethral resection of his trigonal area, pathology demonstrated IM occurring on a background of cystitis glandularis. This case highlights the unusual difficulty in macroscopically diagnosing IM of the bladder compared to other neoplasms of the bladder. Therefore, in patients with persistent visible haematuria there should be a low threshold to perform biopsies.
膀胱肠化生（IM）是一种极为罕见的良性病症。其临床特征与其他膀胱肿瘤相似。其发病机制尚不清楚，并且其作为腺癌前体的作用长期以来一直存在争议。经尿道切除术是IM的主要治疗方式。我们报告了一例49岁男性患者，其表现为肉眼血尿。他接受了多次膀胱镜检查，未发现肉眼可见的异常。影像学检查（CT尿路造影和多参数MRI）显示膀胱颈部有异常，怀疑为肿瘤性病变。在经尿道切除其三角区后，病理显示IM发生在腺性膀胱炎的背景下。该病例凸显了与其他膀胱肿瘤相比，膀胱IM在宏观诊断上存在的异常困难。因此，对于持续出现肉眼血尿的患者，应降低进行活检的阈值。
