Unusual histologic types of high-grade prostatic intraepithelial neoplasia.
Unusual histologic types of high-grade prostatic intraepithelial neoplasia.
复制标题
高级别前列腺上皮内瘤变的异常组织学类型。
DOI：
--
复制
发表时间：
1997
影响因子：
5.6
通讯作者：
P A Humphrey
中科院分区：
文献类型：
--
作者：
Adriana O. Reyes;Paul E. Swanson;Joseph M. Carbone;P A Humphrey
高级别前列腺上皮内瘤变（HGPIN）是前列腺中、低分化腺癌外周带最可能的前体增殖。HGPIN的上皮衬里的通常细胞类型是具有特征性核异常的腺上皮细胞。在这里，我们报告了9例不寻常类型的HGPIN，包括3例印戒细胞HGPIN，1例小细胞神经内分泌HGPIN，和5例HGPIN与独特的粘液特征。三例印戒细胞PIN均与前列腺浸润性原发印戒细胞癌相关。HGPIN呈现典型的簇状和微乳头状结构生长模式，其组成细胞表现出与侵入性印戒细胞相同的形态学外观。上皮内和浸润性印戒细胞粘蛋白阴性，前列腺特异性抗原（PSA）的免疫反应。第四例显示混合上皮内腺-小细胞肿瘤增殖，其中上皮内小细胞与周围浸润性小细胞癌细胞在组织学上相同。小细胞HGPIN和浸润性小细胞癌细胞的神经内分泌标志物嗜铬粒蛋白，突触素和神经元特异性烯醇化酶呈阳性。在5例病例中，HGPIN腺体的粘液性扩张，产生上皮衬里层的平坦图案，构成了HGPIN的第三种不寻常的图案。这些蓝色粘液分泌物很容易检测到苏木精和伊红染色，并组成中性（高碘酸希夫阳性）和酸性（阿新蓝阳性）粘蛋白。在此，我们记录了上皮内增生的肿瘤细胞类型-小细胞神经内分泌和印戒细胞-通常被认为是前列腺中的间质浸润细胞。HGPIN和浸润性癌中这些罕见的前列腺细胞类型的存在为HGPIN和前列腺浸润性癌之间的密切关系提供了进一步的支持。所有三种不常见的HGPIN类型-印戒细胞、小细胞神经内分泌和粘蛋白-对于诊断识别是重要的，因为HGPIN与浸润性癌的关联强度。
High-grade prostatic intraepithelial neoplasia (HGPIN) is the most likely precursor proliferation of peripheral zone, moderately to poorly differentiated prostatic adenocarcinomas. The usual cell type of the epithelial lining of HGPIN is a glandular epithelial cell with characteristic nuclear abnormalities. Here we report nine cases of unusual types of HGPIN, including three cases of signet-ring cell HGPIN, one case of small cell neuroendocrine HGPIN, and five cases of HGPIN with distinctive mucinous features. The three examples of signet-ring cell PIN were all associated with an invasive primary signet-ring cell carcinoma of the prostate. The HGPIN assumed a classical tufted and micropapillary architectural growth pattern, with the constituent cells exhibiting a morphologic appearance identical to that of the invasive signet-ring cells. The intraepithelial and invasive signet-ring cells were mucin negative and were immunoreactive for prostate-specific antigen (PSA). A fourth case displayed a mixed intraepithelial glandular-small cell neoplastic proliferation, where intraepithelial small cells were histologically identical to surrounding invasive small cell carcinoma cells. The small cell HGPIN and invasive small cell carcinoma cells were positive for the neuroendocrine markers chromogranin, synaptophysin, and neuron-specific enolase. In five cases, mucinous distension of HGPIN glands, producing a flat pattern of the epithelial lining layer, comprised the third unusual pattern of HGPIN. These blue mucinous secretions were readily detected by hematoxylin and eosin staining and were composed of both neutral (periodic acid-Schiff-positive) and acidic (alcian blue-positive) mucins. Herein we document the existence of an intraepithelial proliferation of neoplastic cell types-small cell neuroendocrine and signet-ring cell-that are usually considered as stromal-invasive cells in the prostate. The presence of these rare prostatic cell types in both HGPIN and invasive carcinoma provides further support for a close relationship between HGPIN and invasive carcinoma of the prostate. All three unusual types of HGPIN-signet-ring cell, small cell neuroendocrine, and mucinous-are important to diagnostically recognize because of the strength of association of HGPIN with invasive carcinoma.
前列腺穿刺活检中孤立性前列腺上皮内瘤变的形态测量分析和临床随访。
DOI：
10.1097/00005392-199508000-00003
发表时间：
1995
期刊：
The Journal of urology
影响因子：
--
作者：
Keetch,DW;Humphrey,P;Stahl,D;Smith,DS;Catalona,WJ
通讯作者：
Catalona,WJ