Weaver M G, Abdul-Karim F W, Srigley J, Bostwick D G, Ro J Y, Ayala A G
Institute of Pathology, Cleveland, OH 44106.
Am J Surg Pathol. 1992 Jan;16(1):62-8. doi: 10.1097/00000478-199201000-00009.
Paneth cell-like change (PCLC) of the prostatic glandular epithelium was focally observed in one case of normal glandular epithelium, two cases of glandular and stromal hyperplasia, one case of prostatic intraepithelial neoplasia, and four cases of prostatic adenocarcinoma. The distinctive cells were characterized by bright, eosinophilic cytoplasmic granules on routine hematoxylin and eosin-stained material. The cytoplasmic granules in the benign prostatic epithelium were periodate-Schiff's procedure (PAS)-positive and diastase resistant and immunohistochemically negative for lysozyme, neuron-specific enolase, chromogranin, and serotonin. The eosinophilic granules in the prostatic intraepithelial neoplasia and adenocarcinoma cases were immunohistochemically positive for chromogranin, serotonin, and neuron-specific enolase, and negative for lysozyme. By electron microscopy the eosinophilic granules represented exocrine-like or lysosomal-like vesicles in the benign epithelium and neuro-endocrine granules in the malignant epithelium. The lesion represents a prostatic epithelial PCLC rather than a Paneth cell metaplasia. PCLC is the common histological manifestation of two different phenomena: (a) a PAS-positive and diastase-resistant eosinophilic cytoplasmic granular change in benign prostatic epithelium, and (b) endocrine differentiation with neuroendocrine granules in dysplastic and malignant prostatic epithelia. The importance of recognizing PCLC lies in its differentiation from other possible prostatic cytoplasmic inclusions.
在1例正常腺上皮、2例腺性和间质性增生、1例前列腺上皮内瘤变及4例前列腺腺癌中均局灶性观察到前列腺腺上皮的潘氏细胞样改变（PCLC）。在苏木精-伊红常规染色切片上，这些特征性细胞表现为胞质内有明亮的嗜酸性颗粒。良性前列腺上皮中的胞质颗粒过碘酸-希夫反应（PAS）阳性且耐淀粉酶，溶菌酶、神经元特异性烯醇化酶、嗜铬粒蛋白和血清素免疫组化染色均为阴性。前列腺上皮内瘤变和腺癌病例中的嗜酸性颗粒嗜铬粒蛋白、血清素和神经元特异性烯醇化酶免疫组化染色阳性，溶菌酶染色阴性。电镜下，良性上皮中的嗜酸性颗粒代表外分泌样或溶酶体样小泡，恶性上皮中的为神经内分泌颗粒。该病变代表前列腺上皮的PCLC而非潘氏细胞化生。PCLC是两种不同现象的常见组织学表现：（a）良性前列腺上皮中PAS阳性且耐淀粉酶的嗜酸性胞质颗粒改变；（b）发育异常和恶性前列腺上皮中伴有神经内分泌颗粒的内分泌分化。认识PCLC的重要性在于将其与其他可能的前列腺胞质内含物相鉴别。
