Small Cell Carcinoma of the Prostate: An Immunohistochemical Study

Yao, Jorge L.; Madeb, Ralph; Bourne, Patricia A.; Lei, Jiao; Yang, Ximing J.; Tickoo, Satish K.; Liu, Zhengzhi; Tan, Dongfeng; Liu, Cheng; Hatem, Fadi; Huang, Jiaoti; Sant'Agnese, Paul A. di

doi:10.1097/00000478-200606000-00005

Cited by 178 publications

(147 citation statements)

References 49 publications

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“…To establish an accurate diagnosis of nodal Merkel cell carcinoma can be challenging due to lack of cutaneous presentation and presence of a broad [50][51][52] The distinction between nodal Merkel cell carcinoma and small cell melanoma is usually straightforward as melanoma cells express S100 and other melanocytic markers (HMB45, MITF, and MART1).…”

Section: Differential Diagnosis Of Nodal Merkel Cell Carcinomamentioning

confidence: 99%

Merkel cell carcinoma of lymph node with unknown primary has a significantly lower association with Merkel cell polyomavirus than its cutaneous counterpart

Pan

Chen

et al. 2014

Modern Pathology

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Rare cases of Merkel cell carcinoma have been encountered in lymph nodes with unknown extranodal primary, which exhibit similar morphologic and immunophenotypic features to those in primary cutaneous Merkel cell carcinomas. However, it is uncertain whether the nodal Merkel cell carcinoma is a primary tumor of the lymph node or represents a metastasis from an occult or regressed extranodal lesion. To establish an accurate diagnosis of the nodal Merkel cell carcinoma can be challenging because of significant morphologic mimics, including lymphoblastic lymphoma and metastatic small cell carcinoma. Moreover, there is no consensus for a diagnostic term, and many different terms have been used, which can be confusing and may not fully reflect the nature of nodal Merkel cell carcinoma. In this study, we investigated the detailed clinicopathologic features of 22 nodal Merkel cell carcinomas, with comparison to 763 primary cutaneous cases retrieved from the literature. Overall, the nodal and cutaneous Merkel cell carcinomas shared similar clinical presentations, morphologic spectrum, and immunophenotype; both were mostly seen in elderly male with a typical neuroendocrine morphology. Most of cases expressed CK20, synaptophysin, and chromogranin A; and PAX5 and TdT were also positive in majority of cases. However, nodal Merkel cell carcinomas had a significantly lower association with Merkel cell polyomavirus than cutaneous cases (31% vs 76%, P ¼ 0.001). Therefore, these two entities may arise from overlapping but not identical biological pathways. We also recommend the use of the diagnostic term 'Merkel cell carcinoma of lymph node' to replace many other names used.

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Section: Differential Diagnosis Of Nodal Merkel Cell Carcinomamentioning

confidence: 99%

Merkel cell carcinoma of lymph node with unknown primary has a significantly lower association with Merkel cell polyomavirus than its cutaneous counterpart

Pan

Chen

et al. 2014

Modern Pathology

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“…[20][21][22] These criteria include a proliferation of small cells (>4 lymphocytes in diameter) with unique and strict morphological features, scant cytoplasm, ill-defined borders, finely granular 'salt and pepper' chromatin, absent or inconspicuous nucleoli, frequent nuclear molding, and a high mitotic count. Morphological variations of prostatic SCC include intermediate-cell-type tumours with slightly-more-open chromatin and visible small nucleoli seen in about 30-40% of cases-tumours that would probably not be included in the strict diagnosis of SCC of the lung.…”

Section: Pathological Featuresmentioning

confidence: 99%

Small Cell Carcinoma of the Prostate

Wang¹,

Epstein²

2008

American Journal of Surgical Pathology

318

130

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Pure small-cell carcinoma (SCC) of the prostate is a rare entity and one of the most aggressive malignancies of the prostate. Histologically, prostatic SCCs of the prostate are part of a spectrum of anaplastic tumours of the prostate and are similar to SCCs of the lungs. In most cases, SCC of the prostate is associated with conventional prostatic adenocarcinoma. Both components of these mixed tumours frequently share molecular alterations such as ERG gene rearrangements or AURKA and MYCN amplifications, suggesting a common clonal origin. The clinical behaviour of small-cell prostate carcinomas is characterized by extensive local disease, visceral disease, and low PSA levels despite large metastatic burden. Commonly, the emergence of the SCC occurs in patients with high-grade adenocarcinoma who are often treated with androgen deprivation treatment (ADT). However, SCCs do not usually benefit from ADT. A biopsy of accessible lesions is strongly recommended to identify those with SCC pathological features, as management is undoubtedly affected by this finding. Chemotherapy is the standard approach for treating patients with either localized or advanced prostatic SCC. Despite the emergence of moreaggressive treatment modalities, the prognosis of men with prostatic SCC remains dismal.

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“…Wang et al reported a rate of 94%, being CD56 the most sensitive (7). One caveat is that conventional adenocarcinomas, up to 100% in some studies, may focally express these same markers, reinforcing the need for careful morphologic evaluation by the pathologist (5,15,16). More recent discoveries have suggested that prostatic specific membrane antigen (PSMA), CD44 and protein (P501S) may help with indentifying neuroendocrine expression in tumors (7,17).…”

Section: Discussionmentioning

confidence: 99%

Prostatic carcinomas with neuroendocrine differentiation diagnosed in needle biopsies, a morphologic study of 7 cases among 465 sequential biopsies in a tertiary cancer center

et al. 2011

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Purpose: Neuroendocrine carcinomas (NEC) of the prostate are rare, with only a few series hitherto reported. The objective of this study was to assess in a single institution the clinical and morphologic characteristics of neuroendocrine carcinomas diagnosed in needle core biopsies. Materials and Methods:The current study analyses seven cases diagnosed in needle biopsies at a large tertiary regional cancer center from Northeastern Brazil. Two pathologists reviewed specimens retrospectively, and demographic and morphologic characteristics were compared to 458 acinar tumors diagnosed in the same period. Results: There were five small cell carcinomas and two low-grade neuroendocrine carcinomas (carcinoid). NEC were associated with an acinar component in 5/7 cases and the Gleason score of the acinar component was always > 6. The number of cores involved in prostates with NEC was greater (65% compared to 24% of acinar tumors, p < 0.05). The mean PSA at diagnosis was 417.7 (range 5.7-1593, SD 218.3), compared to 100.5 (p = 0.1) of acinar tumors (range 0.3-8545, SD 22.7). Prostates harboring NEC were bigger (p < 0.001, mean volume 240 mL vs. 53 mL of acinar tumors). Treatment of NEC included palliative surgery, chemotherapy, and hormonal therapy. Conclusions: NEC of the prostate is rare and often associated with a high-grade acinar component. Prostates with NEC tend to be larger and involve a greater number of cores than acinar tumors. PSA at diagnosis does not seem to predict the presence of NE tumors in needle biopsy.

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Small Cell Carcinoma of the Prostate: An Immunohistochemical Study

Cited by 178 publications

References 49 publications

Merkel cell carcinoma of lymph node with unknown primary has a significantly lower association with Merkel cell polyomavirus than its cutaneous counterpart

Merkel cell carcinoma of lymph node with unknown primary has a significantly lower association with Merkel cell polyomavirus than its cutaneous counterpart

Small Cell Carcinoma of the Prostate

Prostatic carcinomas with neuroendocrine differentiation diagnosed in needle biopsies, a morphologic study of 7 cases among 465 sequential biopsies in a tertiary cancer center

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