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BN: PHẠM THỊ H., 70t, Nữ • ĐỊA CHỈ: Biên Hòa, Đồng Nai. • KHÁM NGÀY: 09022022. • LÝ DO KHÁM: Nóng thượng vị, trào ngược. • TIỀN CĂN: Nhiễm VGSV C – Viêm dạ dày Hp (+). • Hồ sơ cũ phòng khám ngoài (04012022): Sỏi niệu quản T Thận T ứ nước độ II.
CASE REPORT NHÂN MỘT TRƯỜNG HỢP U NIỆU MẠC BS TRẦN THỊ BẢO CHÂU KHOA SIÊU ÂM - MEDIC • • • BN: PHẠM THỊ H., 70t, Nữ ĐỊA CHỈ: Biên Hịa, Đồng Nai KHÁM NGÀY: 09/02/2022 • LÝ DO KHÁM: Nóng thượng vị, trào ngược • TIỀN CĂN: Nhiễm VGSV C – Viêm dày Hp (+) • Hồ sơ cũ phịng khám ngồi (04/01/2022): Sỏi niệu quản T / Thận T ứ nước độ II HỒ SƠ CŨ HỒ SƠ CŨ SIÊU ÂM SIÊU ÂM SIÊU ÂM SIÊU ÂM SIÊU ÂM XÉT NGHIỆM NỘI SOI NIỆU SINH THIẾT GIẢI PHẪU BỆNH SAU MỔ DISCUSSION * Transitional cell carcinoma, also called urothelial carcinoma,refers to a cancer of the lining of the urinary system * While the majority of urothelial cancers (approximately 90-95%) arise in the bladder, upper tract urothelial cancers (UTUC) correspond to a subset of urothelial cancers that arise in the lining of the kidney (called the renal pelvis) or the ureter * Upper urinary tract urothelial carcinoma (UTUC) comprises approximately 10% of renal neoplasms and around 5% of urothelial carcinomas * Risk factors: Having a personal history of bladder cancer Smoking cigarettes Taking a lot of certain pain medicines, such as phenacetin Being exposed to certain dyes and chemicals used in making leather goods, textiles, plastics, and rubber * Signs and symptoms of transitional cell cancer of the renal pelvis and ureter include blood in the urine and back pain There may be no signs or symptoms in the early stages * The following tests and procedures may be used to diagnose: Physical exam and health history, Urinalysis, Urine cytology, Ultrasound, CT scan, MRI, Ureteroscopy, Biopsy Prognosis * In a multicenter study of 1363 patients with upper urinary tract urothelial carcinoma who were treated with radical nephroureterectomy, the 5-year cancer-specific survival probability was approximately 73% * Patients with stage T3 renal tumors have a better prognosis than those with ureteral tumors * A retrospective study by Park et al found that in patients with stage T3 disease, 5-year cancer-specific survival rates were 77.5% for renal pelvic tumors invading the renal parenchyma versus 49.7% for ureteral tumors invading peripelvic or periureteral fat * The authors suggested that the thickness of the renal parenchyma may protect against local tumor spread Ultrasound Images (Internet) Transitional cell carcinoma with a mass in the left renal pelvis and upper pole calyx Transitional carcinoma in the ureter and bladder Ultrasound Images (Internet) A tumor in the left renal pelvis Dilatated right kidney A tumor in the bladder Bilateral transitional cell carcinoma with a tumor in the left renal pelvis and a tumor in the bladder obstructing the right ureter • Gross examination of the kidney revealed the presence of a whitish mass of 4.5 cm in its maximum size in the renal pelvis and of a second yellowish mass measuring 2.5 cm in the lower renal pole • Histological examination at light microscopy of the first lesion showed a tumor composed of transitional cells arranged in a papillary pattern On the other hand, the second mass was composed of cells with eosinophilic cytoplasm arranged in tubular structures Papillary renal cell carcinoma was diagnosed • The two tumors were not intermingled, but rather separated by normal renal parenchyma https://www.sciencedirect.com/science/article/pii/S2214442015000388 CONCLUSION • Đây trường hợp u niệu mạc bể thận, loại ung thư biểu mô đường niệu gặp U xâm lấn chủ mô thận, chưa qua lớp mỡ, chưa di hạch hay di xa -> tiên lượng tốt • Bệnh nhân phát tình cờ, triệu chứng hệ niệu khơng rõ ràng • Cần kết hợp LS phương tiện CLS để phát bệnh sớm chẩn đốn xác REFERENCES • • • • • • • • • • https://pubmed.ncbi.nlm.nih.gov/17201942/ https://en.m.wikipedia.org/wiki/Renal_pelvis https://www.ultrasoundcases.info/cases/urinary-tract-and-malereproductive-system/kidney-and-ureter/renal-and-ureteric-transitionalcell-carcinoma/ https://www.sciencedirect.com/science/article/pii/S2214442015000388 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150069/ https://www.hopkinsmedicine.org/greenberg-bladder-cancerinstitute/utuc/ https://en.wikipedia.org/wiki/Transitional_cell_carcinoma https://www.cancer.gov/types/kidney/patient/transitional-cell-treatmentpdq https://www.medscape.com/answers/281484-176928/what-is-theprognosis-of-renal-transitional-cell-carcinoma https://pubmed.ncbi.nlm.nih.gov/21412093/ THANK YOU! ... (04/01/2022): Sỏi ni? ?u quản T / Thận T ứ nước độ II HỒ SƠ CŨ HỒ SƠ CŨ SI? ?U ÂM SI? ?U ÂM SI? ?U ÂM SI? ?U ÂM SI? ?U ÂM CT CT XÉT NGHIỆM XÉT NGHIỆM NỘI SOI NI? ?U SINH THIẾT GIẢI PH? ?U BỆNH SAU MỔ DISCUSSION * Transitional... loại ung thư bi? ?u mô đường ni? ?u gặp U xâm lấn chủ mô thận, chưa qua lớp mỡ, chưa di hạch hay di xa -> tiên lượng tốt • Bệnh nhân phát tình cờ, tri? ?u chứng hệ ni? ?u khơng rõ ràng • Cần kết hợp LS... cancers (UTUC) correspond to a subset of urothelial cancers that arise in the lining of the kidney (called the renal pelvis) or the ureter * Upper urinary tract urothelial carcinoma (UTUC) comprises