Varma V A, Fekete P S, Franks M J, Walther M M
Department of Pathology, Atlanta Veterans Administration Medical Center, Decatur 30033.
Diagn Cytopathol. 1988;4(4):300-5. doi: 10.1002/dc.2840040406.
Cells of adenocarcinoma of the prostate (ACP) are infrequently shed in urine. We examined the clinicopathologic features of 22 patients with ACP and tumor cells in urine. Patients typically were clinical stage C or D and had hematuria (13 cases, 59%) and/or obstruction (11 cases, 50%). Prostatic palpation or instrumentation preceded collection of 15 urine specimens. Histologically, tumors were high grade (Gleason score 7-10) and extensive, with involvement of prostatic ducts and acini (10 cases, 45%) and prostatic urethra (5 cases, 23%). Cytologically, the background was clean, and neoplastic cells appeared singly, in loose clusters, as large "casts," or, rarely, in papillary structures. The cells were small, round to oval, with a moderate amount of finely granular or vacuolated cytoplasm; nuclei were generally round with a thin, often irregular membrane, finely granular chromatin, and a single prominent nucleolus. Immunoperoxidase staining for prostatic acid phosphatase and prostate-specific antigen was useful in distinguishing ACP from transitional cell carcinoma.
前列腺腺癌（ACP）细胞很少从尿液中脱落。我们检查了22例ACP伴尿液中肿瘤细胞患者的临床病理特征。患者通常处于临床C期或D期，有血尿（13例，59%）和/或梗阻（11例，50%）。15份尿液标本采集前均有前列腺触诊或器械检查。组织学上，肿瘤为高级别（Gleason评分7 - 10）且范围广泛，累及前列腺导管和腺泡（10例，45%）以及前列腺尿道（5例，23%）。细胞学上，背景干净，肿瘤细胞单个出现、呈松散簇状、形成大的“管型”，或很少呈乳头状结构。细胞小，圆形至椭圆形，有中等量的细颗粒状或空泡状细胞质；细胞核通常圆形，有薄的、常不规则的核膜，细颗粒状染色质，以及单个明显的核仁。前列腺酸性磷酸酶和前列腺特异性抗原的免疫过氧化物酶染色有助于将ACP与移行细胞癌区分开来。
