Organassociated pseudosarcomatous myofibroblastic proliferation of urinary blader: a clinicopathological study of three cases

LI Liang; XU Qing-xia; HAN Cui-hong; ZHOU Feng-juan; CUI Wen

doi:10.3969/j.issn.1007-8096.2017.03.006

Abstract：Objective To explore the clinicopathologic features,diagnosis,differential diagnosis,treatment and prognosis of organ-associated pseudosarcomatous myofibroblastic proliferation of urinary blader (PMP).Methods Three cases of PMP were studied on the clinical characteristics,HE morphology and immunohistochemical characteristics.Related articles were reviewed.Results The major clinical characteristics included painless gross hematuria,urinary urgency and frequency,urine pain or dysuria.Histologicall,lesions most commonly located in the submucosal,the proliferation of spindle cells significantly with disordered arrangement,interspersed within normal muscle layer,often accompanied by more inflammatory cells infiltration,eosinophils were easily noted.The spindle cells had mild atypia,rare mitosis,interstitial myxoid degeneration.Immunohistochemical staining showed that spindle cells were positive for SMA (3/3),calponin (3/3),desmin (2/3),h-caldesmon (1/3) and a series of myogenic markers,and a few spindle cells of two cases were positive for ALK and CK-pan,However,spindle cells of three cases were not expressed in CD34,Dog-1,S-100,β-catenin,Myogenin and MyoD1.Conclusion Organ-associated pseudosarcomatous myofibroblastic proliferation of urinary blader is a kind of benign lesions with false sarcomatoid,and sometimes we misdiagnosed as malignant soft tissue sarcoma because of pseudoinfihrating growth pattern and heterotypic spindle cells.We can make the correct diagnosis according to its clinicopathologic features and immunohistochemical results to avoid excessive clinical treatment.