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病例介绍患者,男性,81岁。因间歇性无痛性全程肉眼血尿11个月入院。尿色鲜红,无血块,无脓尿,无发热,无排尿困难及不适。10年前行前列腺切除术。实验室检查:血常规Hb108g/L,WBC6.3×10~9/L;尿常规:RBC+～+++,尿脱落细胞检查三次阴性。膀胱镜检:右侧壁有一憩室,内有新生物,憩室口约1cm×1cm。B超:膀胱右后壁4.1cm×2.6cm较低回声区,呈憩室状,其内可见不均匀较强回声光斑、亮点。从憩室口凸向膀胱腔。CT:膀胱右后壁实质性肿物向外凸出生长,轮廓尚清楚,密度均匀。膀胱造影:膀胱憩室大小5.2cm×3.2cm,无充盈缺损。1991年9月28日手术,术中见膀胱右后下壁距右侧输尿管口2cm处有憩室,其内有一菜花样肿瘤组织,基底部位于憩室内,向膀胱内生长,肿瘤未穿透膀胱壁及浸润周围组织。行膀胱部分切除术,切口Ⅰ期愈合。病理报告:膀胱移行细胞癌,Ⅲ级。
Case Presentation Patient, male, 81 years old. Due to intermittent painless whole eye hematuria 11 months admission. Urine bright red, no blood clots, no pyuria, no fever, no dysuria and discomfort. 10 years ago underwent prostatectomy. Laboratory tests: blood Hb108g / L, WBC6.3 × 10 ~ 9 / L; urine routine: RBC + ~ +++, urinary cytology examination three negative. Cystoscopy: right side wall has a diverticulum, there are new creatures, diverticulum port about 1cm × 1cm. B super: the right posterior wall of the bladder 4.1cm × 2.6cm lower echogenic zone, diverticula, which can be seen within the uneven strong echo spot, bright spots. From the diverticulum mouth convex bladder cavity. CT: Bladder right posterior wall substantive tumor protruding outward growth, the profile is still clear, uniform density. Bladder imaging: bladder diverticulum size 5.2cm × 3.2cm, no filling defect. September 28, 1991 surgery, intraoperative see the right posterior wall of the bladder from the right ureter orifice 2cm Department diverticulum, which has a cauliflower tumor tissue, the base of the Ministry in the diverticulum, the growth of the bladder, the tumor did not penetrate the bladder Wall and infiltration of surrounding tissue. Bladder partial excision, incision healed. Pathology report: bladder transitional cell carcinoma, grade Ⅲ.