Dondalski M, White E M, Ghahremani G G, Patel S K
Department of Diagnostic Radiology, Evanston Hospital-McGaw Medical Center of Northwestern University, Evanston, IL 60201.
AJR Am J Roentgenol. 1993 Oct;161(4):817-20. doi: 10.2214/ajr.161.4.8372767.
Carcinoma arising within urinary bladder diverticula has a poorer prognosis than do neoplasms that originate within the main bladder lumen as a result of early transmural tumor infiltration. Imaging plays an important role in diagnosing and staging the disease. We describe the radiologic findings in six patients with pathologically proved diverticular carcinomas.
We reviewed the records of six patients who had radiologic examinations and surgically confirmed vesical diverticular carcinomas. The examinations included excretory urography in three patients, cystography in three patients, CT in five patients, and MR imaging in one patient. All patients had hematuria. Five patients had transitional cell carcinoma, and one patient had squamous cell carcinoma.
Three of the tumors manifested as an intraluminal filling defect within a bladder diverticulum on excretory urograms or cystograms. In one patient, CT scans showed a concentric soft-tissue tumor in a diverticular neck. Correlative cystograms showed only smooth narrowing in this area. CT and MR imaging showed a tumor within a large diverticulum, which was not visualized on cystograms because of obstruction at the diverticular orifice.
Imaging plays an important role in identifying bladder diverticula as a potential site of occult neoplasm.
膀胱憩室内发生的癌由于肿瘤早期透壁浸润，其预后比起源于膀胱主腔的肿瘤更差。影像学在该疾病的诊断和分期中起着重要作用。我们描述了6例经病理证实的憩室癌患者的影像学表现。
我们回顾了6例经影像学检查及手术证实为膀胱憩室癌患者的记录。检查包括3例排泄性尿路造影、3例膀胱造影、5例CT及1例磁共振成像（MR成像）。所有患者均有血尿。5例为移行细胞癌，1例为鳞状细胞癌。
3例肿瘤在排泄性尿路造影或膀胱造影上表现为膀胱憩室内的腔内充盈缺损。1例患者的CT扫描显示憩室颈部有同心性软组织肿瘤。相关膀胱造影仅显示该区域有光滑狭窄。CT和MR成像显示一个大憩室内有肿瘤，由于憩室口梗阻，膀胱造影未显示该肿瘤。
影像学在将膀胱憩室识别为隐匿性肿瘤的潜在部位方面起着重要作用。
