Small cell carcinoma of the prostate gland
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| Small cell carcinoma of the prostate gland | |
|---|---|
| Diagnosis in short | |
 Small cell carcinoma of the prostate. H&E stain. | |
|
| |
| LM | small cells with nuclear moulding, stippled chromatin and high NC ratio, +/-high-grade acinar adenocarcinoma (common) |
| LM DDx | small cell carcinoma of the urinary bladder, metastatic small cell carcinoma, poorly differentiated prostate carcinoma |
| IHC | chromogranin A +ve, PSA -ve/+ve |
| Grossing notes | prostate biopsy, prostate chips, radical prostatectomy |
| Staging | prostate cancer staging |
| Site | prostate gland - see prostate cancer |
|
| |
| Prevalence | rare |
| Blood work | PSA low (in relation to conventional cancer) |
| Prognosis | poor |
| Clin. DDx | other types of prostate cancer, metastatic cancer |
| Treatment | chemotherapy |
Small cell carcinoma of the prostate gland is a rare type of prostate cancer with an aggressive course.
The more general topic of prostate cancer with neuroendocrine differentiation is dealt with in a separate article.
General
- Very rare.[1]
- Most common small cell carcinoma outside of the lung.[1]
- Poor prognosis.
- Not graded (ISUP 2005 consensus on Gleason grading system[2]).
Clinical:
- PSA often low in comparison to conventional prostate cancer.[1]
Microscopic
Features:
- Small cells with:
- Nuclear moulding.
- Stippled chromatin.
- High NC ratio.
- +/-High-grade acinar adenocarcinoma, i.e. conventional prostate carcinoma, seen in ~50% of cases.[1]
Notes:
- Similar to small cell carcinoma of the lung.
- High-grade squamoid component favours metastatic urothelial carcinoma.
- UCC usu. HWCK +ve.
DDx:
- Small cell carcinoma of the urinary bladder.
- Lymphoma, large cell.
- Prostate carcinoma with amphicrine features - also have AR staining.[3]
- Other small round cell tumours.
Images
Case
PCNEC - very low mag. (WC)
PCNEC - low mag. (WC)
PCNEC - intermed. mag. (WC)
PCNEC - high mag. (WC)
PCNEC - low mag. (WC)
PCNEC - intermed. mag. (WC)
PCNEC - high mag. (WC)
www
- SmCC of the prostate - low mag. (webpathology.com).
- SmCC of the prostate - high mag. (webpathology.com).
- SmCC of the prostate - low mag. (nih.gov).
- SmCC of the prostate - high mag. (nih.gov).
IHC
Features:[1]
- PSA weak +ve/-ve.
- Chromogranin +ve.
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Furtado, P.; Lima, MV.; Nogueira, C.; Franco, M.; Tavora, F. (2011). "Review of small cell carcinomas of the prostate.". Prostate Cancer 2011: 543272. doi:10.1155/2011/543272. PMID 22110988.
- ↑ Epstein, JI.; Allsbrook, WC.; Amin, MB.; Egevad, LL. (Sep 2005). "The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma.". Am J Surg Pathol 29 (9): 1228-42. PMID 16096414.
- ↑ Prendeville, S.; Al-Bozom, I.; Compérat, E.; Sweet, J.; Evans, AJ.; Ben-Gashir, M.; Mete, O.; van der Kwast, TH. et al. (Dec 2017). "Prostate carcinoma with amphicrine features: further refining the spectrum of neuroendocrine differentiation in tumours of primary prostatic origin?". Histopathology 71 (6): 926-933. doi:10.1111/his.13330. PMID 28756619.