Cina S J, Silberman M A, Kahane H, Epstein J I
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Am J Surg Pathol. 1997 May;21(5):550-5. doi: 10.1097/00000478-199705000-00007.
The presence of normal anatomic structures may be a source of confusion to the pathologist examining prostatic needle biopsies. The morphologic features of Cowper's (bulbourethral) glands incidentally biopsied during transrectal sampling of the prostate have not been described. We reviewed seven cases of Cowper's glands found in prostatic core biopsy specimens. Sections containing Cowper's glands were stained with hematoxylin-eosin, mucicarmine, periodic acid-Schiff's-digest (PAS-D), and antibodies directed at high-molecular-weight cytokeratin (HMWCK), prostate-specific acid phosphatase (PSAP), prostate-specific antigen (PSA), Ulex europaeus agglutinin, and muscle-specific actin. Histologically, Cowper's glands resemble mucinous minor salivary glands entrapped within fascicles of muscle. Lobules of acini composed of cells distended with mucin (mucicarmine and PAS-D positive) were admixed with ducts and ductules composed of hybrid cells with both mucinous and ductular epithelial features. The HMWCK was strongly reactive with the ductular epithelium and demonstrated an attenuated cell lining at the periphery of lobules. The mucinous cytoplasm reacted with U. europaeus, whereas the ductal elements failed to stain. PSAP stains were negative, with PSA positive in most cases. Muscle-specific actin was positive in three cases. Cowper's glands occasionally may be sampled by transrectal needle biopsy. Recognition of this anatomic structure will allow discrimination from low-grade prostatic adenocarcinoma, foamy gland carcinoma, mucinous metaplasia of prostate glands, and atypical glands of undetermined significance.
正常解剖结构的存在可能会给检查前列腺穿刺活检的病理学家带来困惑。经直肠前列腺采样时偶然活检到的考珀氏（尿道球腺）腺的形态学特征尚未见描述。我们回顾了在前列腺芯活检标本中发现的7例考珀氏腺病例。含有考珀氏腺的切片用苏木精-伊红、黏液卡红、过碘酸-希夫消化法（PAS-D）以及针对高分子量细胞角蛋白（HMWCK）、前列腺特异性酸性磷酸酶（PSAP）、前列腺特异性抗原（PSA）、欧洲荆豆凝集素和肌肉特异性肌动蛋白的抗体进行染色。组织学上，考珀氏腺类似于陷入肌束内的黏液性小唾液腺。由充满黏液的细胞（黏液卡红和PAS-D阳性）组成的腺泡小叶与由具有黏液性和导管上皮特征的混合细胞组成的导管和小导管混合存在。HMWCK与导管上皮强烈反应，并在小叶周边显示出变薄的细胞内衬。黏液性细胞质与欧洲荆豆反应，而导管成分不着色。PSAP染色阴性，大多数病例中PSA阳性。3例肌肉特异性肌动蛋白阳性。考珀氏腺偶尔可通过经直肠针吸活检取样。识别这种解剖结构将有助于与低级别前列腺腺癌、泡沫状腺癌、前列腺黏液化生以及意义未明的非典型腺管相鉴别。
