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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (11): 102-107.doi: 10.6040/j.issn.1671-7554.0.2022.0322

• 临床医学 • 上一篇    下一篇

前列腺透明细胞腺癌3例报道并文献复习

朱永村1,赵修世2,孙楠楠3,姚志刚4,周星辰5,牟坤3,6   

  1. 1.威海市立医院病理科, 山东 威海 264200;2.高密市中医院病理科, 山东 高密 261500;3.山东大学齐鲁医院病理科, 山东 济南 250012;4.山东第一医科大学附属省立医院病理科, 山东 济南 250021;5.山东大学第二医院病理科, 山东 济南 250033;6.山东大学基础医学院病理系, 山东 济南 250012
  • 出版日期:2022-11-10 发布日期:2022-11-04
  • 通讯作者: 牟坤. E-mail:mukun@sdu.edu.cn
  • 基金资助:
    国家自然科学基金(81572594)

Prostate clear cell adenocarcinomas: a report of 3 cases and literature review

ZHU Yongcun1, ZHAO Xiushi2, SUN Nannan3, YAO Zhigang4, ZHOU Xingchen5, MU Kun3,6   

  1. 1. Department of Pathology, Weihai Municipal Hospital, Weihai 264200, Shandong, China;
    2. Department of Pathology, Chinese Medicine Hospital of Gaomi, Gaomi 261500, Shandong, China;
    3. Department of Pathology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    4. Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    5. Department of Pathology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    6. Department of Pathology, School of Basic Medical Sciences, Shandong University, Jinan 250012, Shandong, China
  • Online:2022-11-10 Published:2022-11-04

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摘要： 目的 探讨前列腺罕见肿瘤原发透明细胞腺癌(CCA)的临床病理学特征及鉴别诊断。 方法 分析3例前列腺CCA临床病理学特点并复习相关文献。采用一组免疫组化抗体进行鉴别诊断。 结果 3例患者年龄29~54岁;2例发生于前列腺小囊,1例发生于前列腺内。2例临床表现为血精,1例为进行性排尿困难。肿瘤由腺管状、乳头状及实体型三种结构混合存在。腺管和乳头表面可见肿瘤细胞呈鞋钉样排列。3例肿瘤细胞均表达CK7、PAX-8、HNF-1β,部分区域表达AMACR、NapsinA、CA125。术后随访12~15个月,其中1例复发,并肺及腹股沟淋巴结转移;1例未见复发和转移;1例失访。 结论 前列腺原发CCA血清前列腺特异性抗原(PSA)水平不高,可伴有CA125升高,出现血精症状的年轻男性需提高警惕,诊断主要依靠组织病理学检查及免疫表型,发生于前列腺内的较发生于前列腺小囊的预后差。

关键词: 前列腺, 透明细胞腺癌, 诊断, 预后

Abstract: Objective To explore the clinicopathological features and differential diagnosis of primary clear cell adenocarcinoma(CCA)of the prostate. Methods The pathological data of 3 cases of primary prostate CCA were retrospectively analyzed and relevant literature was reviewed. Immunohistochemistry(IHC)was performed with a group of differential antibodies. Results The patients aged 29 to 54 years. The CCA was located in prostatic utricle in 2 cases and in prostatic parenchyma in 1 case. The clinical manifestation was hematospermia in 2 cases and progressive dysuria in 1 case. Microscopically, a mixture of three histological structures were observed, including glandular, papillary and solid patterns. The so-called hobnail pattern was visible in the glandular and papillary surfaces. Immunohistochemically, CK7, PAX-8, HNF-1β were positive, and AMACR, NapsinA, CA125 were partially positive. During the follow-up of 12 to 15 months, 1 patient was lost, 1 developed metastases of the lung and inguinal lymph nodes, and the other had no recurrence or metastasis. Conclusion The serum CA125 level might be elevated while prostate specific antigen(PSA)level is normal for patients with prostate CCA. Young patients with hemospermia should be altered. The diagnosis relies on histopathological examination and immunohistochemical staining. The prognosis of patients with tumor located in prostatic parenchyma is worse than that located in prostatic utricle.

Key words: Prostate, Clear cell adenocarcinoma, Diagnosis, Prognosis

中图分类号: 

  • R365
[1] Grosser D, Matoso A, Epstein JI. Clear cell adenocarcinoma in men: a series of 15 cases [J]. Am J Surg Pathol, 2021, 45(2): 270-276.
[2] Manning J. Case report: transitional cell carcinoma in situ within a urethral diverticulum [J]. Int Urogynecol J, 2012, 23(12): 1801-1803.
[3] Flynn C, Oxley J, McCullagh P, et al. Primary high-grade serous carcinoma arising in the urethra or urethral diverticulum: a report of 2 cases of an extremely rare phenomenon [J]. Int J Gynecol Pathol, 2013, 32(1): 141-145.
[4] Spencer JR, Brodin AG, Ignatoff JM. Clear cell adenocarcinoma of the urethra: evidence for origin within paraurethral ducts[J]. J Urol, 1990, 143(1): 122-125.
[5] Gandhi JS, Khurana A, Tewari A, et al. Clear cell adenocarcinoma of the male urethral tract [J]. Indian J Pathol Microbiol, 2012, 55(2): 245-247.
[6] Klaassen Z, Cleveland C, McCraw CO, et al. Clear cell adenocarcinoma of the prostate: a rare oncologic entity in a 42-year-old African American man [J]. Urology, 2014, 84(5): 997-1000.
[7] Sugimura R, Kawahara T, Noguchi G, et al. Clear cell adenocarcinoma of the prostatic urethra: a case report[J]. IJU Case Rep, 2018, 2(1): 19-22.
[8] Gualco G, Ortega V, Ardao G, et al. Clear cell adenocarcinoma of the prostatic utricle in an adolescent [J]. Ann Diagn Pathol, 2005, 9(3): 153-156.
[9] Chang CW, Yin HL, Li CC. Primary clear cell adenocarcinoma of prostate: a diagnostic challenge [J]. Urol Ann, 2021, 13(4): 434-437.
[10] 刘雯, 袁静萍, 詹娜, 等. 原发性前列腺透明细胞腺癌一例[J]. 中华病理学杂志, 2021, 50(9): 1075-1077. LIU Wen, YUAN Jingping, ZHAN Na, et al. Clear cell adenocarcinoma in the prostate: report of a case [J]. Chinese Journal of Pathology, 2021, 50(9): 1075-1077.
[11] Pan CC, Chiang H, Chang YH, et al. Tubulocystic clear cell adenocarcinoma arising within the prostate [J]. Am J Surg Pathol, 2000, 24(10): 1433-1436.
[12] Oliva E, Amin MB, Jimenez R, et al. Clear cell carcinoma of the urinary bladder: a report and comparison of four tumors of mullerian origin and nine of probable urothelial origin with discussion of histogenesis and diagnostic problems [J]. Am J Surg Pathol, 2002, 26(2): 190-197.
[13] Miller EM, Sun Y, Richardson I, et al. Vesical clear cell adenocarcinoma arising from endometriosis: a mullerian tumor, indistinguishable from ovarian clear cell adenocarcinoma [J]. Gynecol Oncol Rep, 2016, 18: 8-10. doi: 10.1016/j.gore.2016.08.005.
[14] Loizzi V, Cormio G, Leone L, et al. A rare case of primary clear-cell adenocarcinoma of the bladder arising from bladder endometriosis [J]. J Obstet Gynaecol, 2015, 35(7): 758-760.
[15] Kramer MW, Abbas M, Pertschy S, et al. Clear-cell variant urothelial carcinoma of the bladder: a case report and review of the literature [J]. Rare Tumors, 2012, 4(4): e48.
[16] Venyo AK. Clear cell adenocarcinoma of the urethra: review of the literature [J]. Int J Surg Oncol, 2015, 2015: 790235. doi: 10.1155/2015/790235.
[17] Sung MT, Zhang S, MacLennan GT, et al. Histogenesis of clear cell adenocarcinoma in the urinary tract: evidence of urothelial origin [J]. Clin Cancer Res, 2008, 14(7): 1947-1955.
[18] Herawi M, Drew PA, Pan CC, et al. Clear cell adenocarcinoma of the bladder and urethra: cases diffusely mimicking nephrogenic adenoma [J]. Hum Pathol, 2010, 41(4): 594-601.
[19] Patne SC, Johri N, Katiyar R, et al. Renal-type clear cell carcinoma of the prostate: a diagnostic challenge [J]. Diagn Pathol, 2015, 10: 193. doi: 10.1186/s13000-015-0432-8.
[20] Han SI, Lim SC. Rare case of renal-type clear cell carcinoma of the prostate and review of the literature [J]. In Vivo, 2020, 34(5): 2751-2756.
[21] Liao G, Zhang X, Li Z, et al. Renal-type clear cell carcinoma of prostate: a case report and review of literature [J]. Indian J Pathol Microbiol, 2018, 61(3): 431-433.
[22] Warrick JI, Humphrey PA. Foamy gland carcinoma of the prostate in needle biopsy: incidence, Gleason grade, and comparative α-methylacyl-CoA racemase vs. ERG expression [J]. Am J Surg Pathol, 2013, 37(11): 1709-1714.
[23] Han B, Mehra R, Suleman K, et al. Characterization of ETS gene aberrations in select histologic variants of prostate carcinoma [J]. Mod Pathol, 2009, 22(9): 1176-1185.
[24] Friedman GT, Carvalhal EF, Martins JA, et al. Nephrogenic adenoma of the prostate after laser therapy of benign prostatic hyperplasia [J]. Urol Case Rep, 2020, 33: 101382. doi: 10.1016/j.eucr.2020.101382.
[25] Kumar L, Narwal A, Kumar M, et al. Primary clear-cell urothelial carcinoma of urinary bladder: a not-so-clear entity with review of literature [J]. BMJ Case Rep, 2019, 12(10): e231192.
[26] Mai KT, Bateman J, Djordjevic B, et al. Clear cell urothelial carcinoma [J]. Int J Surg Pathol, 2017, 25(1): 18-25.
[27] 温宗华, 张小红, 韦海明. 男性苗勒型透明细胞癌一例[J]. 中华病理学杂志, 2018, 47(1): 63-65.
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