83 Year Old with PSA 0.80 ng/ml and Abnormal DRE

Jefferson B. Lin, M.D.

Specimen Type:

Prostate

History:

83 year old man with PSA 0.8 ng/ml and abnormal DRE underwent 6 core TURS needle biopsy of the prostate.

Pathologic Features:

1 of 6 cores show a mixed adenocarcinoma and high grade neuroendocrine carcinoma (small cell carcinoma) The tumor has a transition pattern with small acinar formation and concsists of small blue cells (Fig 1-2). Immunostains are positive for chromogranin A (Fig 3) and synaptophysin, but negative for 34βE12, p63, or racemase.

Differential Diagnosis:

  • Mixed adenocarcinoma and small cell carcinoma
  • Adenoid cystic/basal cell carcinoma

Diagnosis:

Mixed adenocarcinoma and small cells carcinoma.

Presence of 34βE12, p63 negative tumor cells exclude adenoid cystic/basal cell carcinoma.

References:

  1. Bostwick DG, Cheng L., UROLOGIC SURGICAL PATHOLOGY 2ND EDITION, MOSBY, 2008, p500-507.