Taylor D C, Bhagavan B S, Larsen M P, Cox J A, Epstein J I
Johns Hopkins Hospital Medical Institutions, Baltimore 21287, USA.
Am J Surg Pathol. 1996 Dec;20(12):1481-8. doi: 10.1097/00000478-199612000-00007.
Precursor lesions of papillary urothelial neoplasms have not been well characterized. We reviewed the surgical pathology files of the Johns Hopkins Hospital and three regional hospitals from 1992 to present. Sixteen cases of papillary hyperplasia, defined as undulating urothelium arranged into thin mucosal papillary folds, were identified (in 11 men and five women: age range, 40-89 years). Relative to the diagnosis of papillary hyperplasia, nine patients had a history of papillary urothelial neoplasms; in one of these cases, the patient also had subsequent papillary urothelial neoplasms, and two of these patients had concurrent papillary urothelial neoplasms with papillary hyperplasia. In one of these nine cases, papillary hyperplasia arose in the scar of a prior papillary urothelial neoplasm. In two cases, the patients had concurrent, yet no prior history, of papillary urothelial neoplasms. Of these 11 cases, three had multiple resections showing papillary hyperplasia over time. In case 12, the patient had a history of moderate urothelial atypia. The remaining four patients had no history of papillary urothelial neoplasms or urothelial atypia. We describe papillary hyperplasia as a well-defined entity that is usually asymptomatic and generally found on routine follow-up cystoscopy for papillary urothelial neoplasms. Papillary hyperplasia appears to be a precursor lesion of low-grade papillary urothelial neoplasms.
乳头状尿路上皮肿瘤的前驱病变尚未得到充分的特征描述。我们回顾了约翰霍普金斯医院及三家地区医院从1992年至今的外科病理档案。共识别出16例乳头状增生病例，其定义为起伏不平的尿路上皮形成薄的黏膜乳头状皱襞（11例男性和5例女性，年龄范围40 - 89岁）。相对于乳头状增生的诊断，9例患者有乳头状尿路上皮肿瘤病史；其中1例患者随后还发生了乳头状尿路上皮肿瘤，2例患者同时患有乳头状尿路上皮肿瘤和乳头状增生。在这9例中的1例，乳头状增生出现在既往乳头状尿路上皮肿瘤的瘢痕处。2例患者同时患有乳头状尿路上皮肿瘤，但无既往病史。在这11例中，3例患者多次切除显示随时间推移存在乳头状增生。在病例12中，患者有中度尿路上皮异型增生病史。其余4例患者无乳头状尿路上皮肿瘤或尿路上皮异型增生病史。我们将乳头状增生描述为一种定义明确的实体，通常无症状，一般在对乳头状尿路上皮肿瘤进行常规随访膀胱镜检查时发现。乳头状增生似乎是低级别乳头状尿路上皮肿瘤的前驱病变。
