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NEJM：尿路上皮癌所致的血尿-病例报道

2018-02-01 xing.T MedSci原创

尿路上皮癌血尿吸烟
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吸烟和其他化学暴露是尿路上皮癌的危险因素。对治疗方案进行讨论后，患者选择接受机器人辅助腹腔镜肾膀胱袖状切除术。最后的病理评估显示为输尿管多发性、多灶性尿路上皮癌，手术边界为肿瘤细胞阴性。

患者为一名69岁的女性，因新发肉眼血尿而到急诊就诊。该患者有20包/年的吸烟史。

体格检查、全血计数和代谢试验结果正常。尿检结果显示每个高倍视野中超过100个红细胞和5-10个白细胞。尿培养阴性，尿细胞学检查未见恶性细胞。CT尿路造影显示右输尿管充盈缺损。硬性膀胱镜检查发现膀胱乳头状肿物，在输尿管蠕动时在右侧输尿管口可突出显示。在输尿管镜检查中，确定肿块长度为4厘米，有一个直径为5毫米的圆柱状茎；还发现了许多较小的输尿管远端肿块。病理检查证实为乳头状尿路上皮癌。




吸烟和其他化学暴露是尿路上皮癌的危险因素。对治疗方案进行讨论后，患者选择接受机器人辅助腹腔镜肾膀胱袖状切除术。最后的病理评估显示为输尿管多发性、多灶性尿路上皮癌，手术边界为肿瘤细胞阴性。

术后三个月，该患者情况良好，没有进一步血尿，膀胱镜检查没有发现疾病复发的迹象。

原始出处：

Conan So, et al. Urothelial Carcinoma.N Engl J Med 2018.http://www.nejm.org/doi/full/10.1056/NEJMicm1709216

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    2018-02-06 元元maple

    学习了

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=285554, encodeId=228f28555400, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=76802018286, createdName=元元maple, createdTime=Tue Feb 06 06:49:06 CST 2018, time=2018-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446951, encodeId=551f14469514d, content=<a href='/topic/show?id=259d8906e50' target=_blank style='color:#2F92EE;'>#血尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89067, encryptionId=259d8906e50, topicName=血尿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Fri Feb 02 22:52:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1539309, encodeId=ff81153930927, content=<a href='/topic/show?id=0e802002e45' target=_blank style='color:#2F92EE;'>#上皮癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20027, encryptionId=0e802002e45, topicName=上皮癌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=866a13134648, createdName=mashirong, createdTime=Fri Feb 02 22:52:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284433, encodeId=4e82284433f8, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160304/IMG56D94856B1B5D6405.jpg, createdBy=27931687771, createdName=一个字-牛, createdTime=Fri Feb 02 09:08:07 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=284106, encodeId=348e28410667, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Thu Feb 01 08:19:09 CST 2018, time=2018-02-01, status=1, ipAttribution=)]
    2018-02-02 quxin068

    #血尿#

    0

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    2018-02-02 mashirong

    #上皮癌#

    0

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    2018-02-02 一个字-牛

    学习了谢谢分享

    0

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    2018-02-01 Y—xianghai

    学习了新知识

    0

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