Department of Pathology, Albany Medical Center, Pathology Department MC-81, 47 New Scotland Ave, Albany NY, 12208, USA.
Arch Pathol Lab Med. 2012 Nov;136(11):1447-50. doi: 10.5858/arpa.2011-0359-CR.
A micropapillary variant of prostatic acinar adenocarcinoma has not been reported in the literature. Herein, we report a case of a 50-year-old patient who presented with an elevated prostate-specific antigen concentration and was subsequently diagnosed with prostatic acinar adenocarcinoma on biopsy. Radical prostatectomy specimen revealed prostatic carcinoma with Gleason score 4 + 5 = 9/10, with micropapillary component constituting 80% of tumor volume. Immunohistochemical studies of the prostate carcinoma showed a homogeneously positive prostate-specific antigen and α-methylacyl-CoA racemase, high-molecular-weight cytokeratin, and p63 protein cocktail pattern of staining in both micropapillary and conventional components. Pelvic lymph nodes were negative for metastatic disease. In contrast to the aggressive behavior of micropapillary carcinomas of other organs, the disease in our patient has thus far followed a more benign course, with low stage on presentation and a 2-year follow-up free of disease. However, prognostic correlation should be established on large series in order to assign this variant to a grade category within the Gleason scheme.
前列腺腺癌的微乳头状变体在文献中尚未报道。在此，我们报告了一例 50 岁患者，其前列腺特异性抗原浓度升高，随后在活检中被诊断为前列腺腺癌。根治性前列腺切除术标本显示前列腺癌的 Gleason 评分为 4 + 5 = 9/10，其中微乳头状成分构成肿瘤体积的 80%。前列腺癌的免疫组织化学研究显示，微乳头状和常规成分均呈前列腺特异性抗原和 α-甲基酰基辅酶 A 消旋酶、高分子量细胞角蛋白和 p63 蛋白鸡尾酒染色均匀阳性。盆腔淋巴结无转移性疾病。与其他器官的微乳头状癌的侵袭性行为不同，我们患者的疾病迄今表现出更良性的过程，表现为低分期，并且在 2 年随访中无疾病。然而，为了将这种变体分配到 Gleason 方案中的一个分级类别中，应该在大系列中建立预后相关性。
