Ro J Y, el-Naggar A, Ayala A G, Mody D R, Ordóñez N G
Department of Pathology, the University of Texas M.D. Anderson Hospital and Tumor Institute, Houston 77030.
Am J Surg Pathol. 1988 Jun;12(6):453-60. doi: 10.1097/00000478-198806000-00005.
Primary signet-ring-cell carcinoma of the prostate is extremely rare. We report eight patients with prostatic adenocarcinomas containing significant numbers of signet-ring cells, one of whom presented initially with supraclavicular lymph node metastasis. Patient ages ranged from 50 to 80 years (mean, 67.5). None of the patients had received any form of therapy before biopsy or surgery. All patients presented with advanced disease (five with stage C and three with stage D). All tumors were poorly differentiated adenocarcinomas, M.D. Anderson Hospital system grade IV, Gleason's combined score of 9 or 10. The signet-ring cells were negative for neutral and acid mucins but immunoreactive for prostatic-specific antigen and prostatic acid phosphatase. Ultrastructurally, the signet-ring-cell appearance resulted either from the presence of intracytoplasmic lumina or from vacuoles. Signet-ring cells were also present at the metastatic sites. We conclude that (a) signet-ring-cell carcinoma of the prostate is a variant of poorly differentiated adenocarcinoma of the prostate; and (b) when a metastatic signet-ring-cell carcinoma with negative intracytoplasmic mucin is identified, a prostatic origin should be considered, and prostatic-specific antigen and prostatic acid phosphatase immunostaining should be performed.
前列腺原发性印戒细胞癌极为罕见。我们报告了8例含有大量印戒细胞的前列腺腺癌患者，其中1例最初表现为锁骨上淋巴结转移。患者年龄在50至80岁之间（平均67.5岁）。所有患者在活检或手术前均未接受过任何形式的治疗。所有患者均表现为晚期疾病（5例为C期，3例为D期）。所有肿瘤均为低分化腺癌，MD安德森医院系统分级为IV级，Gleason综合评分为9或10。印戒细胞对中性和酸性粘蛋白呈阴性，但对前列腺特异性抗原和前列腺酸性磷酸酶呈免疫反应性。在超微结构上，印戒细胞的外观要么是由于胞质内管腔的存在，要么是由于空泡。转移部位也存在印戒细胞。我们得出结论：（a）前列腺印戒细胞癌是前列腺低分化腺癌的一种变体；（b）当识别出具有阴性胞质内粘蛋白的转移性印戒细胞癌时，应考虑前列腺起源，并应进行前列腺特异性抗原和前列腺酸性磷酸酶免疫染色。
