Papadimitriou J C, Weihing R R, Choi C, Drachenberg C B
Department of Pathology, School of Medicine, University of Maryland, Baltimore.
Ultrastruct Pathol. 1994 May-Jun;18(3):357-63. doi: 10.3109/01913129409023204.
It has been shown that prostatic adenocarcinoma differentiation correlates with prostatic-specific marker and neuroendocrine expression; that is, the more undifferentiated the tumor, the less it expresses prostatic markers and the more neuroendocrine cells are found in it. Complete absence of prostatic markers together with marked neuroendocrine expression has been associated with small cell morphology. This report describes a case of a metastatic, prostatic marker-negative, non-small cell prostatic adenocarcinoma with a prominent neuroendocrine component. The architecturally well-organized luminal-exocrine cells appeared ultrastructurally undifferentiated, however, displaying an almost empty cytoplasm. This contrasted with the prostatic marker-positive control cases of prostatic carcinoma, which contained relatively numerous cytoplasmic vacuoles. The neuroendocrine cells could be identified by light microscopy as eosinophilic cells. The number of the latter cells was markedly increased in the metastatic foci compared with the primary tumor. Light microscopically and ultrastructurally, the eosinophilic cells in this case differed from the Paneth-like cells described in prostatic carcinoma in previous reports. This case provides support for the general concept of multidirectional differentiation in human epithelial cancers and in particular for the association of poor tumor differentiation with neuroendocrine expression in prostatic carcinoma. In addition, in contrast with previous reports describing absence of basement membrane in metastatic foci of prostatic carcinoma, in the current case well-formed basal laminae were identified.
已表明前列腺腺癌的分化与前列腺特异性标志物及神经内分泌表达相关；也就是说，肿瘤分化程度越低，其前列腺标志物表达越少，且其中发现的神经内分泌细胞越多。前列腺标志物完全缺失并伴有显著神经内分泌表达与小细胞形态相关。本报告描述了一例具有突出神经内分泌成分的转移性、前列腺标志物阴性的非小细胞前列腺腺癌病例。结构上组织良好的管腔 - 外分泌细胞在超微结构上表现为未分化，然而，其细胞质几乎空无一物。这与前列腺癌的前列腺标志物阳性对照病例形成对比，后者含有相对较多的细胞质空泡。神经内分泌细胞在光学显微镜下可被识别为嗜酸性细胞。与原发肿瘤相比，转移灶中后者细胞的数量明显增加。在光学显微镜和超微结构下，该病例中的嗜酸性细胞与先前报告中前列腺癌所描述类似潘氏细胞不同。该病例支持了人类上皮性癌多向分化的一般概念，特别是支持了前列腺癌中肿瘤低分化与神经内分泌表达相关的观点。此外，与先前报告描述前列腺癌转移灶中无基底膜不同，在本病例中识别出了结构良好的基膜。
