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膀胱肾源性腺瘤:一例组织病理学病例报告

Urinary Bladder Nephrogenic Adenoma: A Histopathological Case Report.

作者信息

Popov Hristo, Kirilova Andreya, Naydenova Kristina, Softova Ekaterina, Stoyanov George S

机构信息

General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR.

Pathology, Individual Medical Diagnostic Laboratory City Lab, Varna, BGR.

出版信息

Cureus. 2024 Jun 12;16(6):e62281. doi: 10.7759/cureus.62281. eCollection 2024 Jun.

Abstract

Nephrogenic adenomas are benign lesions that develop within the urinary tract. Most often developing within the urinary bladder, these lesions have a debatable etiopathogenesis, with hamartoma, rest hyperplasia, and transplantation of renal tubular cells being the most widely accepted ones. Nephrogenic adenomas develop more often in adult males, and predisposing factors for their development are prior urinary system injury, infection, or malignancy, with a subset of cases developing in renal transplant patients. Herein, we present a case of a male patient in his seventies who initially presented to our institution with urinary disturbances and was subsequently diagnosed with low-grade, non-invasive urothelial carcinoma. After treatment, the patient remained disease-free for a period of seven calendar years. The current presentation was due to dysuria, and bladder endoscopy revealed a ureteral stricture and two small exophytic lesions neighboring the location of the previously treated urothelial carcinoma. Histology revealed complex papillary architecture and cystic spaces lined by a monolayer of monomorphous epithelial cells with foci of hobnail appearance. The papillary stroma consisted of edematous fibrous tissue with hyperemic blood vessels and focal infiltration by inflammatory cells. Based on the histological findings, the diagnosis of nephrogenic adenoma was established.

摘要

肾源性腺瘤是发生于泌尿道的良性病变。这些病变最常发生于膀胱,其发病机制存在争议,错构瘤、残余增生及肾小管细胞移植是最被广泛认可的发病机制。肾源性腺瘤在成年男性中更为常见,其发病的易感因素包括既往泌尿系统损伤、感染或恶性肿瘤,部分病例发生于肾移植患者。在此,我们报告一例70多岁的男性患者,该患者最初因排尿障碍前来我院就诊,随后被诊断为低级别、非侵袭性尿路上皮癌。治疗后,患者无病生存了7个日历年。此次就诊是由于排尿困难,膀胱内镜检查发现输尿管狭窄以及两个小的外生性病变,位于先前治疗的尿路上皮癌部位附近。组织学检查显示为复杂的乳头结构和囊腔,内衬单层形态单一的上皮细胞,有鞋钉样外观灶。乳头间质由水肿的纤维组织组成,血管充血,有炎症细胞灶性浸润。根据组织学检查结果,确诊为肾源性腺瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/546c/11245664/a97958e61a3d/cureus-0016-00000062281-i01.jpg

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