Haupt Bisong, Ro Jae Y, Ayala Alberto G, Zhai Jim
Department of Pathology, The Methodist Hospital, Weill College of Medicine of Cornell University 6565 Fannin Street, Houston, TX, USA.
Int J Clin Exp Pathol. 2009;2(1):104-7. Epub 2008 May 10.
We report a case of prostatic carcinoma with testicular metastasis, which mimicked malignant lymphoma of the testis. The patient was a 71 year-old man with a history of prostate adenocarcinoma of Gleason score 9 (4+5) diagnosed in 2001 for which he received hormonal therapy. Four years later, the patient developed multiple osteoblastic bone metastases. Radiotherapy of the bone metastases was given with subsequently bilateral orchiectomy for hormonal deprivation therapy in May 2005. Grossly, one of the testes had a subcapsular rubbery 0.9 cm nodule. Microscopically, the nodule was composed of malignant discohesive cells predominantly infiltrating in the interstitium with an appearance of malignant lymphoma. However, immunohistochemical stains were positive for prostate-specific antigen and prostate acid phosphatase and negative for leukocyte common antigen, which confirmed the diagnosis of metastatic prostate adenocarcinoma.
我们报告一例前列腺癌伴睾丸转移病例,该病例酷似睾丸恶性淋巴瘤。患者为一名71岁男性,有前列腺腺癌病史,2001年确诊为Gleason评分9(4+5)的前列腺腺癌,为此接受了激素治疗。四年后,患者出现多发成骨性骨转移。对骨转移灶进行了放射治疗,随后于2005年5月进行双侧睾丸切除术以进行激素剥夺治疗。大体检查发现,其中一个睾丸有一个位于被膜下的、质地似橡胶的0.9 cm结节。显微镜下,该结节由恶性离散细胞组成,主要浸润于间质,外观似恶性淋巴瘤。然而,免疫组化染色前列腺特异性抗原和前列腺酸性磷酸酶呈阳性,白细胞共同抗原呈阴性,这证实了转移性前列腺腺癌的诊断。