Jun Li, Ke Sun, Zhaoming Wang, Linjie Xu, Xinru Yu
Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Int J Surg Pathol. 2008 Jul;16(3):329-34. doi: 10.1177/1066896907309575. Epub 2008 Apr 2.
Two cases of primary prostatic synovial sarcoma presenting as a prostatic mass are presented in patients aged 44 and 46 years. Histologically, both tumors were mainly composed of uniform spindle cells forming interlacing fascicles. Clusters of immature epithelioid cells were also observed among the spindle cells in case 1. Immunohistochemically, the tumor cells of both cases were strongly positive for vimentin, bcl-2, CD99, and E-cadherin, as well as focally positive for cytokeratin. However, they were negative for prostate-specific antigen, S-100 protein, CD34, CD117, muscle-specific actin, desmin, and calretinin. The presence of an SYT-SSX gene fusion resulting from t(X;18) was demonstrated from paraffin blocks by reverse transcriptase polymerase chain reaction in both cases. To the authors' knowledge, these represent the fifth and sixth reported cases of prostatic synovial sarcoma. Accurate diagnosis depends on morphologic and immunohistochemical examination and proper molecular analysis.
本文报告了两例原发性前列腺滑膜肉瘤，表现为前列腺肿块，患者年龄分别为44岁和46岁。组织学上，这两个肿瘤主要由形成交错束状的均匀梭形细胞组成。在病例1的梭形细胞中也观察到不成熟上皮样细胞簇。免疫组化显示，两例肿瘤细胞波形蛋白、bcl-2、CD99和E-钙黏蛋白均呈强阳性，细胞角蛋白呈局灶性阳性。然而，它们前列腺特异性抗原、S-100蛋白、CD34、CD117、肌肉特异性肌动蛋白、结蛋白和钙视网膜蛋白均为阴性。两例病例均通过逆转录聚合酶链反应从石蜡块中证实存在由t(X;18)导致的SYT-SSX基因融合。据作者所知，这些是第五和第六例报告的前列腺滑膜肉瘤病例。准确的诊断依赖于形态学、免疫组化检查和适当的分子分析。
