Hirakawa K, Oomuro H, Hujieda J, Yamashiro K
Department of Urology, Sapporo National Hospital.
Nihon Hinyokika Gakkai Zasshi. 1995 Oct;86(10):1583-6. doi: 10.5980/jpnjurol1989.86.1583.
We reported a case of sarcomatoid carcinoma of the bladder in a 62-year-old man admitted to our hospital because of intermittent macroscopic hematuria. Under the diagnosis of invasive bladder tumor, the patient underwent radical cystectomy and construction of an ileal conduit. Microscopic examination showed a tumor composed of spindle cells that are arranged in a storiform pattern reminiscent of that seen in malignant fibrous histiocytoma without any component of obvious epithelial tumors. Immunohistochemical examination showed that the spindle cells were positive for cytokeratin and we diagnosed the tumor as sarcomatoid carcinoma. The patient has remained well without any evidence of recurrence for 30 months after radical cystectomy. The distinction between sarcomatoid carcinoma that lacks conventional epithelial component and MFH is very difficult and important.
我们报告了一例62岁男性膀胱肉瘤样癌病例，该患者因间歇性肉眼血尿入院。在诊断为浸润性膀胱肿瘤后，患者接受了根治性膀胱切除术及回肠代膀胱术。显微镜检查显示肿瘤由梭形细胞组成，呈席纹状排列，类似于恶性纤维组织细胞瘤，未见明显上皮肿瘤成分。免疫组化检查显示梭形细胞细胞角蛋白阳性，我们将该肿瘤诊断为肉瘤样癌。该患者在根治性膀胱切除术后30个月一直状况良好，无复发迹象。缺乏传统上皮成分的肉瘤样癌与恶性纤维组织细胞瘤的鉴别非常困难且重要。
