Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO 63110, USA.
Histopathology. 2012 Jan;60(1):59-74. doi: 10.1111/j.1365-2559.2011.04039.x.
The vast majority of prostatic cancers are acinar adenocarcinomas. Histological variants of prostatic carcinoma have been variably defined. One approach is to consider two groups of variants. The first group comprises histological variants of acinar adenocarcinoma and the second group non-acinar carcinoma variants or types. Variants of usual acinar adenocarcinoma defined in 2004 by the World Health Organization (WHO) include atrophic, pseudohyperplastic, foamy, colloid, signet ring, oncocytic and lymphoepithelioma-like carcinomas. The second group of non-acinar carcinoma histological variants or types of prostatic carcinoma accounts for about 5-10% of carcinomas that originate in the prostate. These include sarcomatoid carcinoma, ductal adenocarcinoma, urothelial carcinoma, squamous and adenosquamous carcinoma, basal cell carcinoma, and neuroendocrine tumours, specifically small-cell carcinoma. Recently characterized variants not present in the 2004 WHO classification, including microcystic adenocarcinoma, prostatic intraepithelial neoplasia-like adenocarcinoma, large-cell neuroendocrine carcinoma, and pleomorphic giant cell carcinoma, are also described. The aims of this review are to present the essential histomorphological diagnostic attributes of these variants, and to emphasize the clinical signficance of the variants, when different from usual acinar adenocarcinoma, including clinical presentation and outcome.
绝大多数前列腺癌为腺泡腺癌。前列腺癌的组织学变异已经有了不同的定义。一种方法是将两种变异类型分开考虑。第一组包括腺泡腺癌的组织学变异，第二组是非腺泡癌变异或类型。2004 年世界卫生组织（WHO）定义的常见腺泡腺癌的变异包括萎缩性、假增生性、泡沫状、胶样、印戒细胞和嗜酸细胞腺癌。前列腺癌的第二组非腺泡癌组织学变异或类型占起源于前列腺的癌的 5-10%左右。这些包括肉瘤样癌、导管腺癌、尿路上皮癌、鳞状细胞癌和腺鳞癌、基底细胞癌和神经内分泌肿瘤，特别是小细胞癌。最近还描述了 2004 年 WHO 分类中没有的特征变异，包括微囊腺癌、前列腺上皮内瘤样腺癌、大细胞神经内分泌癌和多形性巨细胞癌。本综述的目的是介绍这些变异的基本组织形态学诊断特征，并强调当与常见的腺泡腺癌不同时，变异的临床意义，包括临床表现和预后。
