膀胱淋巴上皮瘤样癌2例并文献复习

发布时间：2018-07-18 11:53

【摘要】：目的探讨膀胱淋巴上皮瘤样癌(lymphoepitheliomalike carcinoma,LELC)的临床病理特点、诊断及鉴别诊断。方法对2例膀胱LELC进行形态学及免疫组化结果观察,并复习相关文献。结果 2例肿瘤最大径4.5~6 cm。镜下2例形态学表现相似,主要由大量合包体样细胞和背景多量淋巴细胞、浆细胞组成,瘤细胞呈巢状、片状、结节样排列,细胞异型明显,核圆形、卵圆形,呈空泡状,胞质丰富,略呈嗜酸性,可见明显小红核仁,可见核分裂象,间质见大量淋巴细胞、浆细胞浸润,伴淋巴滤泡形成,部分区域见大量嗜酸性粒细胞,部分区域肿瘤细胞较密集,炎症细胞稀少,浸润性生长,侵及膀胱肌层或浆膜层。免疫表型:例1肿瘤细胞CK、p53均阳性,CK7、EBER、MLH1、MSH-6、MSH2、PMS2均阴性。例2肿瘤细胞CK、CK(H)、p63均阳性,CK20、EBER、MLH1、MSH-6、MSH2、PMS2均阴性。结论膀胱LELC是一种罕见的膀胱变异性尿路上皮癌,治疗以手术切除和化疗为主,预后较好。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of lymphoepitheliomalike carcinomatoid carcinoma. Methods the morphological and immunohistochemical results of 2 cases of LELC of bladder were observed and the related literatures were reviewed. Results the maximum diameter of tumor was 4.5 cm in 2 cases. The morphologic features of the two cases were similar under microscope. They were mainly composed of a large number of inclusion like cells and background lymphocytes. The tumor cells were nesting, flake, nodular, with a round nucleus, oval shape and vacuole. The cytoplasm was abundant, slightly eosinophilic, with obvious red nucleoli, mitotic, interstitial lymphocytes, plasma cell infiltration, lymphatic follicle formation, eosinophilic granulocytes in some areas and dense tumor cells in some areas. There are few inflammatory cells, infiltrating growth, invading the bladder muscle layer or serous layer. Immunophenotype: in case 1, all the tumor cells were positive for CK7, EBERN, MLH1, MSH-6, MSH2 and PMS2 were all negative. In case 2, CK (H) p63 of tumor cells were all negative. Conclusion bladder LELC is a rare bladder variant urothelial carcinoma. Surgical resection and chemotherapy are the main treatments with good prognosis.
【作者单位】：福建医科大学附属第二医院病理科;福建医科大学省立临床医学院/福建省立医院病理科;
【分类号】：R737.14

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