High-Grade Desmoplastic Foamy Gland Prostatic Adenocarcinoma.

IF 3.7 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY
Guofeng Gao, Jonathan I Epstein
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引用次数: 0

Abstract

Context.—: It is important to recognize high-grade foamy gland prostatic adenocarcinoma with desmoplastic stroma given its aggressive clinical course with frequent metastases and death.

Objective.—: To review the morphology, immunohistochemistry, and prognosis for this rare subtype of prostate adenocarcinoma.

Design.—: Twenty-four cases received for consultation from 2010 to 2021 were analyzed including needle biopsy (n = 21), transurethral resection (n = 2), and a cystoprostatectomy (n = 1).

Results.—: Patients ranged in age from 40 to 89 years (mean, 67 years). On average, 8 cores per case were involved (mean 67% core involvement). Extraprostatic extension and seminal vesicle invasion were observed in 6 of 21 (29%) and 3 of 21 (14%) needle biopsy cases, respectively. Twenty of the 24 cases (83%) were Grade Group (GG) 5 with 4 of 24 (17%) being GG4. Tumor necrosis as a component of Gleason pattern 5 was observed in 21 of 24 cases (88%). Associated intraductal adenocarcinoma (IDC) was observed in 22 of 24 cases (92%), with 4 of 24 cases (17%) demonstrating extensive IDC. Diagnostic challenges were as follows: (1) sparse isolated cancer glands embedded in the dense desmoplastic stroma; (2) fragmented glands; and (3) aberrant staining for high-molecular-weight cytokeratin in a nonbasal cell pattern in all cases. PTEN loss was observed in 9 cases, and p53 nuclear accumulation was observed in 8 cases. Three patients were lost to follow-up. Overall, of the 16 patients with meaningful follow-up, 12 (75%) either had metastases or died from prostate cancer.

Conclusions.—: High-grade desmoplastic foamy gland adenocarcinoma is difficult to diagnose and grade and has a poor prognosis.

高级别结缔组织增生泡沫腺前列腺腺癌。
上下文。结论:高级别泡沫腺前列腺腺癌伴间质增生,其临床病程具有侵袭性,易发生转移和死亡。目的:回顾这一罕见前列腺腺癌亚型的形态学、免疫组织化学和预后。-:对2010年至2021年接受会诊的24例患者进行分析,包括针活检(n = 21)、经尿道切除术(n = 2)和膀胱前列腺切除术(n = 1)。-:患者年龄40 ~ 89岁(平均67岁)。平均每个病例涉及8个核心(平均67%核心受累)。21例穿刺活检患者中有6例(29%)出现前列腺外展,21例中有3例(14%)出现精囊侵犯。24例中有20例(83%)为GG 5级组,4例(17%)为GG4级组。肿瘤坏死作为Gleason模式5的组成部分在24例中有21例(88%)。24例患者中有22例(92%)伴有导管内腺癌(IDC), 24例患者中有4例(17%)表现为广泛的IDC。诊断挑战如下:(1)稀疏的孤立癌腺体嵌埋在致密的间质中;(2)破碎腺体;(3)在所有病例中,高分子量细胞角蛋白的非基底细胞模式异常染色。PTEN缺失9例,p53核积累8例。3例患者失访。总体而言,在16例有意义的随访患者中,12例(75%)发生转移或死于前列腺癌。-:高级别结缔组织增生泡沫腺腺癌难以诊断和分级,预后较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.20
自引率
2.20%
发文量
369
审稿时长
3-8 weeks
期刊介绍: Welcome to the website of the Archives of Pathology & Laboratory Medicine (APLM). This monthly, peer-reviewed journal of the College of American Pathologists offers global reach and highest measured readership among pathology journals. Published since 1926, ARCHIVES was voted in 2009 the only pathology journal among the top 100 most influential journals of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association. Online access to the full-text and PDF files of APLM articles is free.
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