Ghandur-Mnaymneh L, Satterfield S, Block N L
J Urol. 1986 Jun;135(6):1263-6. doi: 10.1016/s0022-5347(17)46066-6.
Small cell carcinomas of the prostate gland are rare, and their histogenesis and clinical behavior remain poorly defined. We report a case with antidiuretic hormone secretion, which demonstrates direct transformation of the adenocarcinoma into the small cell component. The adenocarcinoma reacted positively for prostatic antigen, and negatively for carcinoembryonic antigen and neuron specific enolase, whereas the small cell component was negative for prostatic antigen, and positive for carcinoembryonic antigen and neuron specific enolase. At biopsy this was interpreted as denoting 2 separate tumors: one of prostatic and the other of nonprostatic origin. The clinical course was rapidly fatal but otherwise manifested the metastatic pattern of prostatic carcinoma. We caution that immunohistochemical reactions may be misleading if not interpreted in the context of other findings in the case. This case is labeled as a small cell carcinoma rather than a poorly differentiated adenocarcinoma of the ordinary type because the tumor exhibited morphological, immunohistochemical and biological features typical for that neoplasm.
前列腺小细胞癌较为罕见，其组织发生和临床行为仍不清楚。我们报告1例有抗利尿激素分泌的病例，该病例显示腺癌直接转化为小细胞成分。腺癌对前列腺抗原呈阳性反应，对癌胚抗原和神经元特异性烯醇化酶呈阴性反应，而小细胞成分对前列腺抗原呈阴性反应，对癌胚抗原和神经元特异性烯醇化酶呈阳性反应。活检时，这被解释为代表2个独立的肿瘤：一个起源于前列腺，另一个起源于非前列腺。临床病程进展迅速且致命，但除此之外表现出前列腺癌的转移模式。我们提醒，如果不在病例的其他发现背景下进行解释，免疫组化反应可能会产生误导。该病例被标记为小细胞癌，而非普通类型的低分化腺癌，因为肿瘤表现出该肿瘤典型的形态学、免疫组化和生物学特征。
