临床病例讨论 Case Analysis

尿道前列腺型息肉1例并文献复习

Published at: 2017年第37卷第2期

陈素琴 1 , 袁海洪 1
1 武清区人民医院病理科,天津 301700
通讯作者 素琴 陈 Email: chen_su_qin@126.com
DOI: 10.3978/j.issn.2095-6959.2017.02.037
基金:

摘要

目的:探讨尿道前列腺型息肉的临床病理学特点、诊断及鉴别诊断。方法:收集天津市武清区人民医院诊治的尿道前列腺型息肉1例,收集患者详细的临床资料、实验室检查、病理检查资料、患者的治疗及随访情况,结合文献进行分析。结果:患者,33岁,男性,右侧腰腹部间断疼痛2年。泌尿系超声检查示:右肾盂积水,右输尿管结石。经输尿管钬激光碎石术中发现尿道前列腺部有直径5 mm的息肉一枚。镜下可见肿物被覆两种上皮,为无异型的前列腺型上皮和移行上皮。腺上皮形成腺泡状和乳头状结构,细胞排列为两层。免疫组织化学示基底层细胞胞核表达p63,分泌层细胞胞浆表达PSA,两种细胞均未表达P504s和Ki-67。结合病史、辅助检查及病理组织学,最终诊断为尿道前列腺型息肉。患者经碎石及息肉切除后痊愈,随访2年无复发。结论:尿道前列腺型息肉少见,正确诊断对治疗有重要指导意义。组织学形态需注意与表现为尿道息肉的前列腺导管腺癌等鉴别。诊断需结合病史、临床症状、内镜下表现、组织学及免疫组织化学检查等综合分析。


Prostatic-type epithelial polyp of the urethra: a case report and review of literature

Abstract

Objective: To investigate the clinicopathologic features, diagnosis and differential diagnosis of prostatic-type epithelial polyp of the urethra. Methods: A case of prostatic-type epithelial polyp of the urethra from People’s Hospital of Wuqing was selected. We collected the clinical data, laboratory and pathological examination data, the treatment and follow-up of the patients, and analyzed the data with a literature review. Results: A 33-year-old man presented with a 2-year history of waist-abdomen. Ultrasonography of urinary tract showed right hydronephrosis and ureteral calculi. Ureteroscopic revealed a polypoid lesion (the diameter of 5 mm) located in the prostatic urethra during holmium laser lithotripsy. Microscopic sections showed acini and papillae with true fibrovascular cores lined by benign-appearing prostatic epithelium with admixed benign urothelium. Prostatic-type epithelial polyp consisted of an outer row of secretory cells and a subjacent layer of basal cells. Immunohistochemically, the cytoplasm of secretory cells were positive for PSA, and the nucleus of basal cells were positive for P63. Both of them were negative for P504s and Ki-67. Other causes of papillary lesion were excluded on the base of medical history, histopathology and other accessory examinations before the diagnosis of prostatic-type epithelial polyp. The patient had a complete remission after fragmentation and cystoscopic excision without recurrence for two years during the follow-up. Conclusion: Prostatic-type epithelial polyp of the urethra is rare and timely diagnosis is important for successful therapy. Histological differential diagnoses should include prostatic ductal adenocarcinoma presenting as a urethral polyp, etc. The final diagnosis should be based on histological examination combined with the patient history, clinical manifestation, endoscopy finding, histomorphological and immunostaining testing.


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引用

引用本文: 素琴 陈, 海洪 袁. 尿道前列腺型息肉1例并文献复习[J]. 临床与病理杂志, 2017, 37(2): 443-447.
Cite this article as: CHEN Suqin, YUAN Haihong . Prostatic-type epithelial polyp of the urethra: a case report and review of literature[J]. Journal of Clinical and Pathological Research, 2017, 37(2): 443-447.