Tran K P, Epstein J I
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Am J Surg Pathol. 1996 Nov;20(11):1346-50. doi: 10.1097/00000478-199611000-00005.
We describe two cases of mucinous adenocarcinomas involving and confined to the prostate and originating from the prostatic urethra. These cases were identical to adenocarcinomas arising within the urinary bladder and differed from mucinous adenocarcinoma of the prostate. In both cases, an in situ adenocarcinoma component was identified in the overlying prostatic urethra. In one case the in situ adenocarcinoma arose in a villous adenoma of the urethra. Both cases contained lakes of mucin lined by tall columnar epithelium with varying degrees of cytologic atypia, and one case had mucin-positive signet cells. In contrast, mucinous adenocarcinomas of the prostate demonstrate tubules and cribriform glands floating within mucin; mucin-positive signet cells are rare. Both tumors were negative immunohistochemically for prostate-specific antigen and prostate-specific acid phosphatase and positive for carcinoembryonic antigen. One case was treated by radical prostatectomy, and the patient was without evidence of disease with short follow-up. Following simple prostatectomy, the other patient did not undergo definitive therapy for several years, at which point the tumor had progressed locally to an advanced stage. In terms of therapy, the distinction between mucinous adenocarcinoma or urinary bladder-type arising in the prostate depicted within the current study and mucinous adenocarcinoma of the prostate is significant.
我们描述了两例黏液腺癌，累及并局限于前列腺，起源于前列腺尿道。这些病例与膀胱内发生的腺癌相同，与前列腺黏液腺癌不同。在这两例中，均在上覆的前列腺尿道中发现原位腺癌成分。其中一例原位腺癌发生于尿道绒毛状腺瘤。两例均有由高柱状上皮衬覆的黏液湖，伴有不同程度的细胞异型性，且一例有黏液阳性印戒细胞。相比之下，前列腺黏液腺癌表现为漂浮在黏液中的小管和筛状腺体；黏液阳性印戒细胞罕见。两种肿瘤免疫组化检测前列腺特异性抗原和前列腺特异性酸性磷酸酶均为阴性，癌胚抗原为阳性。一例接受了根治性前列腺切除术，短期随访后患者无疾病证据。另一例患者在单纯前列腺切除术后数年未接受确定性治疗，此时肿瘤已局部进展至晚期。在治疗方面，本研究中描述的起源于前列腺的黏液腺癌或膀胱型与前列腺黏液腺癌之间的区别具有重要意义。
