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Nephrogenic Adenoma of the Urinary Bladder: A Review of the Literature

机译:膀胱的肾源性腺瘤:文献综述。

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摘要

Background. Nephrogenic adenoma of the urinary bladder (NAUB) is a rare lesion associated with nonspecific symptoms and could inadvertently be misdiagnosed. Aim. To review the literature. Methods. Various internet search engines were used. Results. NAUB is a benign tubular and papillary lesion of the bladder, is more common in men and adults, and has been associated with chronic inflammation/irritation, previous bladder surgery, diverticula, renal transplantation, and intravesical BCG; recurrences and malignant transformations have been reported. Differential diagnoses include clear cell adenocarcinoma, endocervicosis, papillary urothelial carcinoma, prostatic adenocarcinoma of bladder, and nested variant of urothelial carcinoma; most NAUBs have both surface papillary and submucosal tubular components; both the papillae and tubules tend to be lined by a single layer of mitotically inactive bland cells which have pale to clear cytoplasm. Diagnosis may be established by using immunohistochemistry (positive staining with racemase; PAX2; keratins stain positive with fibromyxoid variant), electron microscopy, DNA analysis, and cytological studies. Treatment. Endoscopic resection is the treatment but recurrences including sporadic malignant transformation have been reported. Conclusions. There is no consensus on best treatment. A multicentre study is required to identify the treatment that would reduce the recurrence rate, taking into consideration that intravesical BCG is associated with NAUB.
机译:背景。膀胱肾源性腺瘤(NAUB)是一种罕见的病灶,伴有非特异性症状,可能会被误诊。目标。回顾文献。方法。使用了各种互联网搜索引擎。结果。 NAUB是膀胱的良性管状和乳头状病变,在男性和成人中更常见,并且与慢性炎症/刺激,先前的膀胱手术,憩室,肾移植和膀胱内BCG相关;已经报道了复发和恶性转化。鉴别诊断包括透明细胞腺癌,宫颈癌,乳头状尿路上皮癌,膀胱前列腺腺癌和尿路上皮癌的巢状变体。大多数NAUBs都具有表面乳头状和粘膜下管状成分。乳头和肾小管都倾向于被单层有丝分裂无活性的温和细胞衬里,这些细胞的细胞质变白至透明。诊断可以通过免疫组织化学(消旋酶阳性染色; PAX2;角蛋白染色,纤维胶体变体阳性),电子显微镜,DNA分析和细胞学研究来确定。治疗。内镜下切除术是治疗方法,但已报道复发,包括偶发性恶性转化。结论。最佳治疗尚无共识。考虑到膀胱内卡介苗与NAUB相关联,需要进行多中心研究来确定可降低复发率的治疗方法。

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