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首页> 外文期刊>Modern Pathology >Urothelial (Transitional Cell) Papilloma of the Urinary Bladder: A Clinicopathologic Study of 26 Cases
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Urothelial (Transitional Cell) Papilloma of the Urinary Bladder: A Clinicopathologic Study of 26 Cases

机译：膀胱膀胱尿路上皮性乳头状瘤26例临床病理研究

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The existence of a papillary lesion of the urinary bladder with a benign clinical course and recognizable morphologic features that merit the benign categorization "papilloma" has been controversial. The clinical aspects and histologic features of these lesions remain to be fully elucidated. We have studied the clinicopathologic features of 26 patients with urothelial papillomas and correlated them with outcome. Papillomas occurred in two distinct clinical settings: (1) de novo neoplasms (23/26) or (2) those occurring in patients with a known clinical history of bladder cancer ("secondary" papillomas; 3/26). Follow-up information was available in 14/23 of the de novo cases (mean = 39 mo) and in 3/3 secondary cases (mean = 24 mo). Patients with de novo papillomas had a mean age of 46 years; 16 were male and 7 were female. Twelve of 14 had a benign clinical course with no recurrences; 1 developed a recurrent papilloma at 3 years, and 1 developed a pT3a high-grade papillary urothelial carcinoma at 4 years. Patients with secondary papillomas had a mean age of 66 years; two were male and one was a female. One of these patients developed two additional recurrences, and two patients had no new recurrences. Morphologically, the papillary architecture ranged from a common simple, nonhierarchical arrangement to, infrequently, more complex anastomosing papillae with budding. The individual papillae ranged from small (most common), with scant stroma and slender fibrovascular cores, to large, with marked stromal edema and/or cystitis cystica-like urothelial invaginations. Common to all was a lining of normal-appearing urothelium without hyperplasia, maintenance of normal polarity, and frequent prominence of the umbrella cell layer. Overall, no patient with a diagnosis of papilloma died of disease; only one patient with a de novo lesion (7.0%) had a recurrent papilloma, and 1/14 (7.0%) progressed to a higher grade and stage of disease, although this patient was on immunosuppressive therapy secondary to a renal transplant. De novo urothelial papillomas occur in younger patients and usually have a benign course. Urothelial papillomas are histologically and probably biologically distinctive tumors and merit distinction from other higher risk papillary neoplasms of the urinary bladder.
机译：具有良性临床过程和值得良性归类“乳头状瘤”的可识别的形态学特征的膀胱乳头状病变的存在一直是有争议的。这些病变的临床方面和组织学特征仍有待充分阐明。我们研究了26例尿路上皮乳头状瘤患者的临床病理特征，并将其与预后相关。乳头状瘤发生在两种不同的临床环境中：（1）新生肿瘤（23/26）或（2）发生在有已知膀胱癌临床病史的患者中（“继发性”乳头状瘤; 3/26）。在从头病例中有14/23（平均= 39 mo）和在继发病例中有3/3（平均= 24 mo）可获得随访信息。新生乳头状瘤患者的平均年龄为46岁。男性16位，女性7位。 14例中有12例临床过程良好，无复发。 1例在3年时复发，1例在4年时发展为pT3a高度乳头状尿路上皮癌。继发性乳头状瘤患者的平均年龄为66岁。两个是男性，一个是女性。其中一名患者再发两次复发，两名患者没有新的复发。从形态上讲，乳头状结构的范围从普通的简单，无层次的排列，到不常见的有芽的更复杂的吻合乳头。单个乳头的范围从小（最常见），间质少，纤细的血管芯，到大，具有明显的间质水肿和/或膀胱炎，膀胱样尿道上皮内陷。共同的是正常出现的尿道上皮没有增生，维持正常极性和伞状细胞层频繁突出。总体而言，没有诊断出乳头状瘤的患者死于疾病。尽管只有一位患有新生病变的患者（7.0％）复发了乳头状瘤，而1/14（7.0％）的病情进展和疾病分期更高，尽管该患者正在接受肾脏移植后的免疫抑制治疗。新生尿路上皮乳头状瘤发生在年轻患者中，通常具有良性病程。尿路上皮乳头状瘤是组织学上可能是生物学上独特的肿瘤，与其他较高风险的膀胱乳头状肿瘤有区别。

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