患者男性,54岁。因尿痛、尿频、尿血伴进行性消瘦4月余于1988年11月23日入院。入院检查:慢性消耗性病容,全身浅表淋巴结未触及,心肺正常。小便常规:红细胞(+++)、白细胞(+)、蛋白(++)。膀胱造影:膀胱粘膜凹凸不平,容积缩小,约50ml。CT、B超均显示双侧肾盂积水。膀胱镜检:粘膜充血、水肿,三角区粘膜粗糙。临床诊断:泌尿系结核?膀胱肿瘤?经抗结核治疗效果不佳,一周后行膀胱镜活检。病理报告为膀胱印戒细胞癌。在硬膜外麻醉下行膀胱切除术,术中见膀胱前壁增厚、变硬似“革袋状”,前列腺及后尿道前壁皆受侵犯。髂窝及主动脉旁淋巴结肿大、质硬、固定并融合成块。病理检查:全切膀胱一个,大小8×6×4 Male patient, 54 years old. Due to dysuria, frequent urination, hematuria with progressive weight loss more than 4 months in November 23, 1988 admission. Admission examination: chronic wasting disease, systemic superficial lymph nodes not touched, normal heart and lung. Urine routine: red blood cells (+++), white blood cells (+), protein (++). Bladder imaging: Bladder mucosa uneven, reduced volume, about 50ml. CT, B-ultrasound showed bilateral hydronephrosis. Cystoscopy: mucosal congestion, edema, mucosa rough triangle. Clinical diagnosis: Urinary tract tuberculosis? Bladder cancer? Anti-TB treatment ineffective, a week after cystoscopy biopsy. Pathological report of bladder signet ring cell carcinoma. Under epidural anesthesia under cystectomy, intraoperative see the anterior wall thickening of the bladder, harden like “leather bag”, prostate and posterior urethral anterior are infringed. Iliac fossa and para-aortic lymph nodes, hard, fixed and fused into blocks. Pathological examination: all cut a bladder, the size of 8 × 6 × 4