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- 请教老师膀胱肿物，乳头状瘤？低级别尿路上皮癌？
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wangdingding 离线
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本帖最后由 quhong 于 2012-03-15 02:09:11 编辑
引用 27 楼 清秋 在 2012-03-14 10:19:20 的发言:
谢谢quhong老师，本病例伞细胞还存在，细胞异型性也不大，怎么不诊断具有恶性潜能的尿路上皮乳头状瘤呢？
新手上路，谢谢老师指点
The histologic differences between papillary neoplasms of low malignant potential and papillary carcinoma of low grade may be subtle. However, some cells within papillary low grade carcinoma are overtly neoplastic, whereas cells in tumors of low malignant potential lesions show at most only nuclear enlargement. Low grade papillary carcinomas may invade the lamina propria, and have a low (<5%) risk of further progression, although they frequently recur (The World Health Organization/International Society of Urological Pathology Consensus Classification of Urothelial (Transitional Cell) Neoplasms of the Urinary Bladder, The American Journal of Surgical Pathology Issue: Volume 22(12), December 1998, pp 1435-1448).
引用 31 楼 quhong 在 2012-03-15 01:41:48 的发言:
本帖最后由 quhong 于 2012-03-15 02:09:11 编辑
引用 27 楼 清秋 在 2012-03-14 10:19:20 的发言:
谢谢quhong老师，本病例伞细胞还存在，细胞异型性也不大，怎么不诊断具有恶性潜能的尿路上皮乳头状瘤呢？
新手上路，谢谢老师指点
The histologic differences between papillary neoplasms of low malignant potential and papillary carcinoma of low grade may be subtle. However, some cells within papillary low grade carcinoma are overtly neoplastic, whereas cells in tumors of low malignant potential lesions show at most only nuclear enlargement. Low grade papillary carcinomas may invade the lamina propria, and have a low (<5%) risk of further progression, although they frequently recur (The World Health Organization/International Society of Urological Pathology Consensus Classification of Urothelial (Transitional Cell) Neoplasms of the Urinary Bladder, The American Journal of Surgical Pathology Issue: Volume 22(12), December 1998, pp 1435-1448).
以上描述的具有恶性潜能的尿路上皮乳头状瘤与低级别乳头状尿路上皮癌之间的区别实际上很难把握。有人甚至提出应去掉具有恶性潜能的尿路上皮乳头状瘤这一分类。我深知我自己的弱点，不能精确把握它们之间的区别，所以我索性很少用具有恶性潜能的尿路上皮乳头状瘤这一诊断。当然，每人应量力而行。我平时感觉，有无伞细胞存在，对诊断帮助也不大。不知你体会如何？
