Gohji K, Sugimoto M, Hamami G, Kamidono S, Ishigami J, Maeda S, Sugiyama T
Hinyokika Kiyo. 1985 Apr;31(4):693-9.
This paper presents an autopsy case of primary malignant lymphoma of the urinary bladder. The patient, a 63-year-old man, consulted us because of macroscopic hematuria. Cystoscopy revealed a bladder tumor, which was diagnosed as an anaplastic cell carcinoma by transurethral punch biopsy. The tumor progressively increased in size, despite treatment with preoperative antineoplastic chemotherapy consisting of CDDP. Only ureterocutaneostomy and biopsy were performed at the operation although total cystectomy and ileal conduit had been planned, because the tumor had invaded into the perivesicular tissue. Biopsy revealed B cell lymphoma, which was characterized by specific staining with IgG by the PAP method. Although antineoplastic chemotherapy was performed again after operation, the patient gradually weakened and died 5 months after admission. At autopsy, a hen-egg sized, non-papillary tumor which invading into the perivesicular tissue was found at the anterior wall of the urinary bladder. There were many metastatic nodules in the thraco-lumbar vertebral columns, para-aortic lymphnodes and mesenteric lymphnodes. Lungs and liver were free from metastatic tumors.
本文介绍了一例膀胱原发性恶性淋巴瘤的尸检病例。患者为一名63岁男性,因肉眼血尿前来就诊。膀胱镜检查发现膀胱肿瘤,经尿道穿刺活检诊断为间变性细胞癌。尽管采用了由顺铂组成的术前抗肿瘤化疗方案,肿瘤仍逐渐增大。手术时,尽管原计划进行全膀胱切除术和回肠代膀胱术,但由于肿瘤已侵犯膀胱周围组织,仅进行了输尿管皮肤造口术和活检。活检显示为B细胞淋巴瘤,通过PAP法用IgG进行特异性染色可对其进行表征。术后再次进行了抗肿瘤化疗,但患者逐渐衰弱,入院5个月后死亡。尸检时,在膀胱前壁发现一个鸡蛋大小、无乳头的肿瘤,该肿瘤已侵犯膀胱周围组织。在胸腰椎、主动脉旁淋巴结和肠系膜淋巴结中有许多转移结节。肺和肝脏未发现转移瘤。