膀胱憩室内にみられたNephrogenic adenomaの2例

Abstract

症例1:81歳男.肉眼的血尿を主訴とした.尿沈査WBC 10～15/hpfと膿尿を認めた.経尿道的に腫瘍の生検を行ったところ悪性細胞はみられなかった為, 膀胱憩室摘除術を施行した.膀胱腫瘍の病理組織診断はNephrogenic adenomaであった.間質には炎症細胞の浸潤がみられた.症例2:50歳男.排尿困難, 肉眼的血尿を主訴した.尿沈査でWBC 20～30/hpfと膿尿を認め, 尿培養でB群β-streptcoccusを10^5個/ml以上検出した.内視鏡的膀胱憩室焼灼術を施行した.肉眼的には高分化の表在性膀胱腫瘍によく似た形態の乳頭状腫瘍を3個認めた.内視鏡的にこれを切除の後, 憩室内全面を焼灼した.病理組織学的診断はnephrogenic adenomaであった.術後6ヵ月時点で腫瘍の再発はみられておらず, 憩室容量も著明な減少をみている

We report two cases of a nephrogenic adenoma in the bladder diverticulum. The first patient was an 81-year-old man with gross hematuria. Cystoscopy revealed bladder diverticulum and a papillary tumor within. Bladder diverticulectomy was performed and the histopathological diagnosis was a nephrogenic adenoma. The second patient was a 50-year-old man with gross hematuria and dysuria. Transabdominal ultrasound revealed bladder diverticulum. Transurethral coagulation of the bladder diverticulum was performed. Then three papillary tumors were detected, and were resected transurethrally. The histopathological diagnosis was a nephrogenic adenoma. These are the first and second cases of a nephrogenic adenoma in the bladder diverticulum reported in Japan.