Transitional Cell Carcinoma of the Prostate

Algaba, Ferrán; Santaularia, J M; Lamas, M. J.; Ayala, Gustavo

doi:10.1159/000472462

Cited by 13 publications

(7 citation statements)

References 14 publications

(30 reference statements)

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“…Amin et al, and the members of the ISUP Immunohistochemistry in Diagnostic Urologic Pathology Group ( 17 ) have found that on the basis of the differential diagnostic consideration, positivity for GATA3, CK20, p63, and either high–molecular weight cytokeratin or cytokeratin 5/6 are quite useful to support urothelial differentiation in the appropriate clinicopathologic context. All these antibodies are suitable in distinguishing high grade urothelial carcinomas versus poorly differentiated prostatic carcinomas because the histological and clinical distinction is frequently difficult to establish ( 1 , 15 – 18 ).…”

Section: Discussionmentioning

confidence: 99%

Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

et al. 2016

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PurposeThe vast majority of urothelial carcinomas infiltrating the bladder are consistent with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied.Materials and MethodsWe describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes. Needle biopsies were performed. At endoscopy bladder tumors were found in both cases.ResultsBoth biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma. In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin (34BetaE12) and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years.ConclusionsThe diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients.

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Section: Discussionmentioning

confidence: 99%

Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

et al. 2016

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“…Njinou et al reviewed the degree to which extension from urothelial carcinoma into the prostate af-fects the survival [3]. They also compared whether prostatic stromal invasion occurring via direct extension through the bladder wall differs from stromal invasion arising intraurethrally.…”

Section: Classificationmentioning

confidence: 99%

“…The differential diagnosis includes high-grade urothelial carcinoma extending into the bladder neck and prostate versus poorly differentiated prostate adenocarcinoma extending into the bladder [3]. Since both tumours can present with similar high-grade histological and nuclear features, distinction by haematoxylin-eosin alone can be difficult.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…The difference is of clinical value as well, since the distinction alters both therapy and cancer staging. In these situations, immunohistochemical stains may help distinguish one origin from the other [3,[5][6][7][8][9]. For instance, carcinoma in the bladder neck area was definitively attributed to urothelial origin, since the foci with prostatic extension stained for CK7 and CK20 but not PSA, PAP, or CD57.…”

Section: Differential Diagnosismentioning

confidence: 99%

“…Although the prognosis is poor even with only apparent DCIS, histologic recognition is essential, because the only possibility of improved outcome is early and aggressive treatment [1]. Radical cystoprostatectomy is the pure type of primary urothelial carcinoma of the prostate [3].…”

Section: Treatmentmentioning

confidence: 99%

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Prostatos urotelio karcinoma, diagnozuota atlikus biopsiją. Klinikinis atvejis ir literatūros apžvalga

Sruogis¹,

Mickys²,

Petraitis³

et al. 2005

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Algimantas Sruogis1, Ugnius Mickys2, Tadas Petraitis1, Edita Kaubrienė3, Feliksas Jankevičius11 Vilniaus universiteto Onkologijos institutoUrologijos skyrius,Santariškių g. 1, LT-08661 VilniusEl paštas: sruogis@loc.lt2 Lietuvos nacionalinis patologijos centras3 Vilniaus universiteto Onkologijos institutoIntervencinės echoskopijos irultragarsinės diagnostikos skyrius Tikslas Nustatyti diagnostinius prostatos urotelio karcinomos kriterijus, diferencijuojant urotelio karcinomą, peraugančią šlapimo pūslės kaklelį ir prostatą, nuo prostatos adenokarcinomos, peraugančios šlapimo pūslę. Atvejis Pacientas, 37 metų, trejus metus gydytas nuo lėtinio prostatito. Prostatos sekrete nustačius atipinių ląstelių, įtarus prostatos vėžį, ligonis nusiųstas į VU Onkologijos institutą. Tyrimo pro tiesiąją žarną, cistoskopijos, rentgenologinio, ultragarso ir serumo žymenų tyrimo duomenimis, diddesnių pokyčių nerasta. Atlikus transuretrinę šlapimo pūslės gleivinės biopsiją (TUR) iš šlapimo pūslės sienelių, kaklelio ir šlaplės prostatinės gleivinės, histologiškai nustatyti normalūs urotelio audiniai. Šlapimo citologinis tyrimas buvo neigiamas. Atlikus transrektalinę prostatos biopsiją, diagnozuotas prostatos urotelio navikas, imunohistochemiškai neigiamas PSA (prostatos specifiniam antigenui) ir teigiamas citokeratinams CK8 ir CK HMW. Pacientui buvo atlikta radikali cistoprostatektomija, pašalinti dubens limfmazgiai ir suformuotas šlapimo nuotėkis į ileum segmentą, išvestą į priekinę pilvo sieną (Brycker būdu). Morfologinė diagnozė – prostatos urotelio karcinoma. Taip pat diagnozuota prostatos adenokarcinoma ir prostatos intraepitelinė neoplazija. Po 15 mėnesių PSA lygis buvo 0,2 ng/ml, jokių ligos progresavimo požymių nepasireiškė. Remiantis šiuo klinikiniu atveju straipsnyje apžvelgiama literatūra, aiškinantis prostatos urotelio karcinomos ir adenokarcinomos skirtumus. Išvados Diagnozuojant prostatos urotelio karcinomą reikia vadovautis tam tikrais kriterijais: 1) prostatos urotelio karcinoma turi būti verifikuota makro-, mikroskopiškai ir imunohistocheminiais metodais, 2) neturėtų būti kitų urotelio karcinomos židinių organizme. Būtent prostatos biopsija leidžia patologui nustatyti tikslią diagnozę prieš operaciją. Imunohistocheminis tyrimas padeda atlikti diferencinę diagnostiką. Po operacijos tiriant pašalintus audinius, diagnozė patikslinama histomorfologiškai, naudojant imunohistocheminius tyrimus, net jei ir labai retai nustatoma prostatos urotelio karcinoma. Reikšminiai žodžiai: prostatos vėžys, urotelio karcinoma, prostatos urotelio karcinoma, prostatos biopsija Prostate urothelial carcinoma diagnosed on prostatic needle biopsy. Case report with literature overview Algimantas Sruogis1, Ugnius Mickys2, Tadas Petraitis1, Edita Kaubrienė3, Feliksas Jankevičius11 Vilnius University Institute of Oncology,Urology Department,Santariškių str. 1,LT-08661 Vilnius, LithuaniaE-mail: sruogis@loc.lt2 Lithuanian National Centre of Pathology3 Vilnius University Institute of Oncology,Radiology Department Objective To establish criteria for the diagnosis of primary urothelial prostate carcinoma after the differential diagnosis including high-grade urothelial carcinoma extending into the bladder neck and prostate versus poorly differentiated prostate adenocarcinoma extending into the bladder. Case report The patient was a 37-year-old man with severe prostatism symptoms, who presented with an atypical seminal vesicles fluid cytological test result. The prostate was also normal by the digital examination, endoscopy, roentgenography, ultrasonography and serum markers. A diagnostic transurethral resection of bladder mucosa, bladder neck specimen revealed normal urothelial tissues. The urine cytological test result was negative. The transrectal biopsy of the prostate revealed an urothelial carcinoma with a negative staining of PSA (prostate-specific antigen) and positive of cytokeratins CK 8 and CK HMW. The patient subsequently underwent radical cystoprostatectomy and pelvic lymphadenectomy with ileal conduit m. Brycker creation. The histological diagnosis was the urothelial carcinoma of the prostate. Also, the prostate showed foci of High Grade PIN and prostate adenocarcinoma. After 15 months the patient has a PSA level of 0.2 ng/mL, no symptoms, no evidence of progression. Based on this case of the urothelial carcinoma of prostate, the literature was reviewed and the morphological differentiation between urothelial carcinoma and adenocarcinoma of the prostate was discussed. Conclusions The diagnostic criteria are the following: (1) the tumor should be a macro-, microscopically and imunohistochemically verified as urothelial carcinoma localized exclusively in the prostate gland; (2) there must be no other primary urothelial carcinoma in the body. These criteria can be readily applied when evaluating surgical resection specimens. With the use of radiologically guided or endoscopically derived biopsies, however, the pathologist is increasingly called upon to make a diagnosis before definitive surgical resection. In these circumstances, the pathologist will often resort to immunostains to help refine the differential diagnosis. Moreover, even when surgical resection specimens are evaluated, immunostains are still used in conjunction with histomorphology to confirm the diagnosis, particularly when a rare entity such as primary urothelial prostate carcinoma is encountered. Keywords: prostate cancer, urothelial carcinoma, prostate urothelial carcinoma, prostatic needle biopsy

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