PDF(Pubmed)
Abstract：
Inflammatory myofibroblastic tumour (IMT) is a rare tumour with an intermediate biological behaviour. It usually occurs in children and adolescents, primarily in the abdomen or lungs. Histopathologically, IMT consists of spindle cells, i.e., myofibroblasts, and a variable inflammatory component. Localization in the urinary bladder is rare. We are presenting a rare case of IMT in the bladder in a middle-aged man treated by partial cystectomy. A 62-year-old man consulted a urologist because of haematuria and dysuric disturbances. A tumorous mass was detected by an ultrasound in the urinary bladder. CT urography described the tumorous mass at the dome of the urinary bladder measuring 2 × 5 cm. A smooth tumorous mass was cystoscopically observed at the dome of the urinary bladder. Transurethral resection of the bladder tumour was performed. Histopathological analysis of the specimen identified spindle cells with a mixed inflammatory infiltrate; immunohistochemical findings showed positivity for anaplastic lymphoma kinase (ALK), smooth muscle actin (SMA) and vimentin. A histopathological diagnosis of IMT was established. It was decided that the patient would undergo a partial cystectomy. A complete excision of the tumour from the dome of the urinary bladder with surrounding healthy tissue was performed. Histopathological and immunohistochemical findings of the sample confirmed the diagnosis of IMT, without the presence of the tumour at the surgical margins. The postoperative course went smoothly. IMT is a rare tumour in adults, especially localised in the urinary bladder. IMT of the urinary bladder is difficult to distinguish from urinary bladder malignancy both clinically and radiologically, as well as histopathologically. If the location and size of the tumour allow it, bladder-preserving surgeries such as partial cystectomy represent a reasonable modality of operative treatment.
摘要：
炎性肌纤维母细胞瘤（IMT）是一种罕见的肿瘤，具有中等生物学行为。它通常发生在儿童和青少年，主要在腹部或肺部。组织病理学,IMT由梭形细胞组成，即，肌成纤维细胞，和可变的炎症成分。膀胱中的定位很少见。我们正在介绍一例罕见的中年男子膀胱部分切除术治疗的膀胱IMT病例。一名62岁的男子因血尿和排尿困难而咨询了泌尿科医生。通过超声在膀胱中检测到肿瘤肿块。CT尿路造影描述了膀胱圆顶处的肿瘤肿块，大小为2×5厘米。膀胱镜检查在膀胱穹顶处观察到光滑的肿瘤肿块。对膀胱肿瘤进行经尿道切除术。标本的组织病理学分析确定梭形细胞具有混合的炎症浸润;免疫组织化学结果显示为间变性淋巴瘤激酶（ALK）阳性，平滑肌肌动蛋白（SMA）和波形蛋白。建立了IMT的组织病理学诊断。决定患者将接受部分膀胱切除术。从具有周围健康组织的膀胱穹顶完全切除肿瘤。样本的组织病理学和免疫组织化学结果证实了IMT的诊断，在手术边缘没有肿瘤的存在。术后进展顺利。IMT是成人罕见的肿瘤，尤其是位于膀胱。膀胱的IMT在临床和放射学上都很难与膀胱恶性肿瘤区分开来，以及组织病理学。如果肿瘤的位置和大小允许，膀胱部分切除术等保留膀胱手术是一种合理的手术治疗方式。
