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【专题】前列腺病理集锦(未完待续)

前列腺非典型性腺瘤样增生 34bE12 免疫染色

上一张局灶性AAH进行细胞角蛋白34bE12 免疫染色显示碎片状基底细胞层。

The immunostain for high molecular weight cytokeratin 34bE12 demonstrates fragmented basal cell layer in the previous focus of AAH.


前列腺非典型性腺瘤样增生

在AAH中高倍镜下看不到细胞非典型性。

Note the lack of cytologic atypia in AAH at high magnification.


前列腺萎缩后增生(Post-atrophic Hyperplasia)

簇状萎缩的前列腺腺泡伴发增生性改变。低倍镜下容易误当作腺癌,尽管如此,仍缺乏典型的癌细胞特征,如核仁显著等。

Clusters of atrophic prostatic acini with proliferative changes. At low magnification, it may be mistaken for adenocarcinoma; however, they lack cytologic features of cancer such as prominent nucleoli.


前列腺萎缩后增生(高倍镜下)

该片很难跟前列腺腺癌相鉴别。高分子量细胞角蛋白免疫染色具有极其重要的意义。

This case is not difficult to distinguish from prostatic adenocarcinoma. In challenging cases, the immunostain for high molecular weight cytokeratin is invaluable (see next image). Post-atrophic hyperplasia: A histologic mimic of adenocarcinoma. Am J Surg Pathol 19(9): 1068-1076, 1995 .


前列腺萎缩后增生-34bE12免疫染色

经过高分子量细胞角蛋白34bE12免疫染色后,绝大多数腺体显示完整明显的基底细胞层。

The majority of the glands show a prominent basal cell layer with the immunostain for high molecular weight cytokeratin 34bE12.


前列腺透明细胞筛状增生(Clear Cell Cribriform Hyperplasia)

前列腺腺体的小叶簇伴有筛状结构。

Lobular clusters of glands with cribriform architecture.


前列腺透明细胞筛状增生

簇状分布的腺体已经突入腺腔。胞浆透明或苍白,呈嗜酸性染色。胞核大小均匀,核仁不明显。基底细胞清晰可见。

The glandular clusters have punched out lumens. The cytoplasm is clear or pale eosinophilic. The nuclei are uniform and lack nucleoli. Basal cells can be clearly seen.


间质性增生伴非典型性(Stromal Hyperplasia with Atypia)

大的非典型细胞伴有核浓染,包含核内空泡,分散于良性腺体之间。

Large atypical cells with hyperchromatic nuclei containing intranuclear vacuoles are interspersed between benign glands. Prostatic stromal hyperplasia with atypia: A study of 11 cases. Journal of Urologic Pathology, 6:15-26, 1997 .


前列腺结节性增生(Prostate - Nodular Hyperplasia)

前列腺中叶异常增生,表现为息肉样肿物,突入膀胱腔内。

Hyperplasia of the median lobe of the prostate produces a polypoid mass that protrudes in the bladder lumen.


很实际的问题,希望大家多多努力,新年快乐
谢谢斑竹,受益匪浅!
六、前列腺内皮瘤(Prostatic Intraepithelial Neoplasia,PIN)


高分级PIN(High-grade PIN )

High-grade PIN consists of intermediate to large size preexisting glands with proliferative changes resulting in hyperchromatic appearance. Note the small foci of cancer adjacent to PIN on the upper left and lower right.


高分级PIN-簇状型(High-grade PIN – Tufted Variant)

Six variants of high-grade PIN have been described – tufted, micropapillary, flat, cribriform, small cell type, and the most recent addition – inverted type. The image depicts tufted variant. Note the enlarged nuclei, prominent nucleoli and residual basal cells.


高分级PIN-微乳头状型(High-grade PIN – Micropapillary Variant)

The acinar epithelial cells are arranged in long, delicate, finger-like structures in this micropapillary variant. Atrophic acini are present at the bottom of the image.


高分级PIN-扁平型(High-grade PIN - Flat Pattern)

The acinar epithelial cells are pseudostratified and arranged linearly in this example of flat variant of high-grade PIN. There is nuclear and nucleolar enlargement. Note the prominent apical snouts.


高分级PIN-筛状型(High-grade PIN - Cribriform Pattern)

n cribriform high-grade PIN interconnecting bridges of acinar epithelial cells extend across the lumen of the glands.


高分级PIN-筛状型(High-grade PIN - Cribriform Pattern)

Distinction of cribriform variant of high-grade PIN from adenocarcinoma may at times be extremely difficult. Immunostain for high molecular weight cytokeratin 34bE12 may be useful in such cases – basal cell layer is fragmented in PIN and absent in adenocarcinoma.


高分级PIN-簇状型(High-grade PIN - Tufted Pattern)

Another example of tufted variant of high-grade PIN.


高分级PIN和癌-34bE12免疫染色(High-grade PIN & Cancer - 34bE12 Immunostain)

The benign glands on upper right have continuous basal cell layer; high-grade PIN glands in the middle have fragmented basal cell layer; malignant glands on the left completely lack basal cell layer.


高分级PIN-核仁显著(High-grade PIN - Prominent Nucleoli)

This example of high-grade PIN shows all the classic histologic features: intermediate-to-large size preexisting glands displaying nuclear and nucleolar enlargement and fragmented basal cell layer.


高分级PIN-核仁显著(High-grade PIN - Prominent Nucleoli)

Another classic example of high-grade PIN, showing tufted and flat patterns.


太好了,谢谢斑竹
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