Lomax-Smith J D, Seymour A E
Am J Surg Pathol. 1980 Dec;4(6):565-72. doi: 10.1097/00000478-198012000-00007.
The association between analgesic nephropathy and urothelial cancer, usually in the renal pelvis, is well established. We report two such patients in whom careful morphologic study of nephrectomy specimens demonstrated severe and extensive urothelial dysplasia, with focal carcinoma in situ and grossly invisible invasive tumors. In one of these patients, no gross lesion was apparent in the urothelium. These findings support the development of invasive carcinoma through a phase of carcinoma in situ caused by the action of carcinogenic analgesic metabolites in the urine. Further, they indicate the need for caution in the assessment of urinary cytologic atypia and for care in the examination of excised urothelium in those patients.
镇痛剂肾病与通常发生在肾盂的尿路上皮癌之间的关联已得到充分证实。我们报告了两名此类患者，对其肾切除标本进行的仔细形态学研究显示，存在严重且广泛的尿路上皮发育异常，伴有局灶性原位癌以及肉眼不可见的浸润性肿瘤。在其中一名患者中，尿路上皮未发现明显的肉眼病变。这些发现支持了致癌性镇痛剂代谢产物在尿液中的作用导致原位癌阶段进而发展为浸润性癌的观点。此外，它们还表明在评估尿细胞学异型性时需要谨慎，并且在检查这些患者切除的尿路上皮时要仔细。
