Arista-Nasr Julian, Martinez-Benitez Braulio, Camorlinga-Tagle Nancy, Albores-Saavedra Jorge
Department of Pathology, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Tlalpan D.F. 14000, México.
Ann Diagn Pathol. 2008 Oct;12(5):349-55. doi: 10.1016/j.anndiagpath.2008.04.006. Epub 2008 Jul 7.
Foamy gland carcinoma is an uncommon variant of prostatic carcinoma. Foamy microcarcinoma of the prostate has not been studied in detail in needle biopsy. We describe here useful criteria for the diagnosis of foamy gland microcarcinoma of the prostate in needle biopsy. We reviewed 6 cases of foamy gland microcarcinoma. All tumors measured less than 1 mm and involved less than 5% of the biopsied tissue. A range of 4 to 40 foamy neoplastic glands were found in the 6 tumors. The original diagnosis of foamy gland microcarcinoma was made in 3 cases. They were composed of 21 to 40 glands lined by cuboidal to columnar cells with abundant foamy cytoplasm and small picnotic nuclei. Infiltrating and nodular patterns were readily identified, and absence of basal cells was shown by cytokeratin stains. The remaining 3 cases were designated as atypical foamy glands and consisted of similar but fewer glands (4-20). The diagnosis of foamy gland microcarcinoma was not made because of lack of nucleomegaly and prominent nucleoli and because an infiltrating pattern was less apparent. Subsequent biopsies confirm the diagnosis of microcarcinoma. The number of glands lined by voluminous foamy cells with hyperchromatic nuclei, an infiltrating pattern, and the absence of basal cells with high-molecular-weight cytokeratin were the most useful features in the diagnosis of foamy microcarcinoma. The presence of few atypical foamy glands in needle biopsy requires detailed analysis because they may represent foamy gland microcarcinoma.
泡沫状腺腺癌是前列腺癌的一种罕见变体。前列腺泡沫状微癌在针吸活检中尚未得到详细研究。我们在此描述前列腺针吸活检中泡沫状腺微癌诊断的有用标准。我们回顾了6例泡沫状腺微癌病例。所有肿瘤直径均小于1毫米，累及的活检组织少于5%。在这6个肿瘤中发现了4至40个泡沫状肿瘤性腺管。最初诊断为泡沫状腺微癌的有3例。它们由21至40个腺管组成，内衬立方状至柱状细胞，细胞质丰富呈泡沫状，细胞核小且固缩。浸润性和结节性模式易于识别，细胞角蛋白染色显示基底细胞缺失。其余3例被定为非典型泡沫状腺管，由类似但数量较少的腺管（4 - 20个）组成。因缺乏核肿大和明显核仁且浸润模式不太明显而未做出泡沫状腺微癌的诊断。后续活检证实为微癌。内衬大量泡沫状细胞且细胞核深染、浸润模式以及高分子量细胞角蛋白染色显示基底细胞缺失，这些是诊断泡沫状微癌最有用的特征。针吸活检中出现少数非典型泡沫状腺管需要详细分析，因为它们可能代表泡沫状腺微癌。
