Prostate urothelial carcinoma diagnosed on prostatic needle biopsy. Case report with literature overview
Journal Title: Lietuvos Chirurgija - Year 2005, Vol 3, Issue 4
Abstract
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.
Authors and Affiliations
Algimantas Sruogis, Ugnius Mickys, Tadas Petraitis, Edita Kaubriene, Feliksas Jankevicius
Immediate postoperative transfusions after total hip arthroplasty: retrospective analysis comparing two methods of predicting post-transfusion hematocrit
Background / objective. Total hip arthroplasty is associated with significant bleeding, which continues through early postoperative hours. Choosing the amount of packed red blood cells (PRBC) for transfusion to reach he...
Traumatic duodenal injuries: further study
Background / objective. To evaluate the results of surgical management of duodenal injuries. Patients and methods. A retrospective analysis of all patients with surgically identified duodenal injuries treated over a...
Prostatos urotelio karcinoma, diagnozuota atlikus biopsiją. Klinikinis atvejis ir literatūros apžvalga
Tikslas. Nustatyti diagnostinius prostatos urotelio karcinomos kriterijus, diferencijuojant urotelio karcinomą, peraugančią šlapimo pūslės kaklelį ir prostatą, nuo prostatos adenokarcinomos, peraugančios šlapimo pūslę....
Galūnių venų raidos defektų chirurginis gydymas
Įvadas / tikslas. Venų raidos defektų diagnozė turi būti nustatyta kuo ankstesniu gyvenimo laikotarpiu. Daugelis šios ligos simptomų ir požymių gali būti priskirti paprasčiausiai venų varikozei arba hemangiomai. Todėl c...
Prostate urothelial carcinoma diagnosed on prostatic needle biopsy. Case report with literature overview
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...