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中华腔镜泌尿外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 550 -554. doi: 10.3877/cma.j.issn.1674-3253.2022.06.013

病例研究

膀胱副神经节瘤五例的临床和影像学特征报告并文献复习
刘卫敏1, 彭令荣1, 戎黛琳1, 康庄1, 胡成2,()   
  1. 1. 510630 广州,中山大学附属第三医院放射科
    2. 510630 广州,中山大学附属第三医院泌尿外科
  • 收稿日期:2021-11-04 出版日期:2022-12-01
  • 通信作者: 胡成
  • 基金资助:
    中山大学高校基本科研业务费专项资金(22qntd3401)

Clinical manifestations and imaging features of paraganglioma of urinary bladder of 5 cases and literature review

Weimin Liu1, Lingrong Peng1, Dailing Rong1, Zhuang Kang1, Cheng Hu2,()   

  1. 1. Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
    2. Department of Urology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China
  • Received:2021-11-04 Published:2022-12-01
  • Corresponding author: Cheng Hu
引用本文:

刘卫敏, 彭令荣, 戎黛琳, 康庄, 胡成. 膀胱副神经节瘤五例的临床和影像学特征报告并文献复习[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(06): 550-554.

Weimin Liu, Lingrong Peng, Dailing Rong, Zhuang Kang, Cheng Hu. Clinical manifestations and imaging features of paraganglioma of urinary bladder of 5 cases and literature review[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(06): 550-554.

目的

总结分析膀胱副神经节瘤的临床和影像学特征。

方法

回顾性分析我院2012年12月至2020年7月经手术病理证实的5例膀胱副神经节瘤的患者资料,分析其临床和影像学特征,并进行文献复习。

结果

5例患者临床仅1例表现为无明显诱因尿频、尿急、尿痛,余4例均为体检偶然发现。CT、MRI均显示膀胱占位性病变,1例位于肌壁间,椭圆形,表面光滑,4例位于膀胱黏膜下,形态不规则,表面凹凸不平。CT平扫密度偏高、均匀,未见囊变、坏死、钙化,MRI T1WI及T2WI均显示等稍高信号,增强扫描瘤灶明显强化,黏膜下病灶均与邻近膀胱壁分界不清,局部膀胱壁增厚、强化。

结论

膀胱副神经节瘤是一种少见的膀胱良性肿瘤,无症状的膀胱副神经节瘤术前常误诊为膀胱癌。正确认识其影像学表现,结合典型临床表现,术前可提示该病的诊断,有助于泌尿外科医师手术方式的选择,避免术中并发症的发生。

Objective

To investigate the clinical manifestations and imaging features of paraganglioma of the urinary bladder (PUB).

Methods

The clinical manifestations, pathological and imaging features of five patients with pathologically proved PUB were analyzed retrospectively between Dec. 2012 to Jul. 2020 in our hospital, and related literatures were reviewed.

Results

Only 1 patient of the five presented with dysuria, urinary frequency and urgency, the other 4 cases were found by chance in physical examination. All the 5 lesions presented as solid mass on CT or MRI imaging features,1 was intramural, oval shape with smooth surface, 4 were submucosal, irregular shape with uneven surface. All lesions had homogeneous density without cystic, necrosis or calcification. MRI showed slightly higher signal intensity on both T1WI and T2WI, focal enhancement was obvious. Submucosal lesions were indistinct with the adjacent bladder wall, and local bladder wall was thickened and enhanced.

Conclusions

PUB is a rare type of benign lesions, those asymptomatic PUB were often misdiagnosed as malignant neoplasm pre-operatively. Familiarity with the imaging features, combined with typical clinical manifestations, bladder paraganglioma should be considered as a differential diagnosis to neoplasm before operation, which is helpful for the urologists to make correct surgical methods and avoid complications during operation.

表1 五例膀胱肿瘤患者的临床特征
图4 膀胱副神经节瘤患者病理图
表2 五例膀胱肿瘤患者的影像学特征
[1]
Qin J, Zhou G, Chen X. Imaging manifestations of bladder paraganglioma[J]. Ann Palliat Med, 2020, 9(2): 346-351.
[2]
Alanee S, Williamson SR, Gupta NS. A rare case of non-functioning bladder paraganglioma treated with robotic assisted partial cystectomy[J]. Urol Case Rep, 2019, 26: 100950.
[3]
Romano IJ, Gentile F, Lippolis A. Postmicturition syndrome: a neglected syndrome dangerous for the bladder and the heart[J]. J Am Soc Hypertens, 2018, 12(8): 589-593.
[4]
Zhai H, Ma X, Nie W, et al. Paraganglioma of the Urinary Bladder: A Series of 22 Cases in a Single Center[J]. Clin Genitourin Cancer, 2017, 15(5): e765- e771.
[5]
侯国良, 徐文峰, 刘建华, 等. 膀胱副神经节瘤6例临床病理分析 [J/CD].中华腔镜泌尿外科杂志 (电子版), 2019, 13(4): 234-237.
[6]
Bosserman AJ, Dai D, Lu Y. Imaging characteristics of a bladder wall paraganglioma[J]. Clin Nucl Med, 2019, 44(1): 66-67.
[7]
张瑞敏, 张建国, 赵永祥. 双极电刀经尿道切除膀胱副神经节瘤一例[J/CD].中华腔镜泌尿外科杂志(电子版), 2017, 11(2): 139-140.
[8]
熊丙建, 江铎, 唐明忠, 等. 膀胱副神经节瘤二例[J/CD].中华腔镜泌尿外科杂志(电子版), 2016, 10(5): 63-64.
[9]
Hanji AM, Rohan VS, Patel JJ, et al. Pheochromocytoma of the urinary bladder: a rare cause of severe hypertension[J]. Saudi J Kidney Dis Transpl, 2012, 23(4): 813-816.
[10]
Zimmerman IJ, Biron RE, Macmahon HE. Pheochromocytoma of the urinary bladder[J]. N Engl J Med, 1953, 249(1): 25-26.
[11]
Park S, Kang SY, Kwon GY, et al. Clinicopathologic characteristics and mutational status of succinate dehydrogenase genes in paraganglioma of the urinary bladder: a multi-institutional Korean study[J]. Arch Pathol Lab Med, 2017, 141: 671-677.
[12]
Male M, Ye T, Tao J, et al. Differentiating nonfunctional paraganglioma of the bladder from urothelial carcinoma of the bladder: pitfalls and breakthroughs[J]. BioMed Research International, 2019, 1097149.
[13]
Cheng L, Leibovich BC, Cheville JC, et al. Paraganglioma of the urinary bladder: can biologic potential be predicted? [J]. Cancer, 2000, 88(4): 844-852.
[14]
Lu H, Male M, Jiang K. Clinical significance of functional and anatomical classifications in paraganglioma of the urinary bladder [J]. Urol Oncol, 2019, 37(6): 354.e9-e17.
[15]
Li H, Xie J, CHen Z, et al. Diagnosis and treatment of a rare tumor-bladder paraganglioma[J]. Mol Clin Oncol, 2020,13(4): 40.
[16]
Henderson SJ, Kearns PJ, Tong CM, et al. Patients with urinary bladder paragangliomas: a compiled case series from a literature review for clinical management [J]. Urology, 2015, 85(5): e25-e29.
[17]
Loveys FW, Pushpanathan C, Jackman S. Urinary bladder paraganglioma: AIRP best cases in radiologic-pathologic correlation [J]. Radiographics, 2015, 35(5): 1433-1438.
[18]
牛琳, 荣璐璐, 蒋涛. 膀胱副神经节瘤的多层螺旋CT诊断价值[J].实用放射学杂志, 2021, 37(6): 965-967.
[19]
Li W, Yang B, Che JP, et al. Diagnosis and treatment of extra-adrenal pheochromocytoma of urinary bladder: case report and literature review [J]. Int J Clin Exp Med, 2013, 6(9): 832-839.
[20]
Alayli AEI, Amine MAE, Hout YEI, et al. Functioning metastatic paraganglioma of the urinary bladder in a 10-year-old child[J]. BMJ Case Rep, 2017, 2017: bcr-2017-220533 .
[21]
Liang J, Li H, Gao L, et al. Bladder paraganglioma: clinicopathology and magnetic resonance imaging study of five patients [J]. Urol J, 2016, 13(2): 2605-2611.
[22]
Mithqal A, Darvishi P, Rehm P. MIBG localization of a subclinical paraganglioma of the bladder [J]. Clin Nucl Med, 2017, 42(4): e196-e198.
[23]
范大铬, 吴春林, 黄海建, 等. 膀胱副神经节瘤23例临床病理学分析[J].中华病理学杂志, 2020, 49(4): 311-316.
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