Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of urethral nephrogenic adenoma involving the prostate are described. A diagnosis of prostatic carcinoma was raised in both cases and was seriously entertained in one of them. The patients, who were 65 and 68 yr old, underwent transurethral resection because of difficulty voiding; both had had a prior similar procedure. Microscopic examination in each case showed small tubules and clusters of cells in the fibromuscular stroma of the prostate. In one case the lesional cells had abundant clear cytoplasm, and in both cases some of the nuclei had prominent nucleoli. In each case a minor component of the cystic pattern of nephrogenic adenoma was also present. Features pointing to a diagnosis of nephrogenic adenoma were a morphology that was diagnosis of nephrogenic adenoma were a morphology that was focally characteristic of that lesion, an origin from overlying prostatic urethra in both cases, and negative immunohistochemical staining of the lesional cells for prostate-specific antigen and prostate-specific acid phosphatase. These cases illustrate that nephrogenic adenoma occasionally involves the prostate and in these cases can potentially be confused with prostatic adenocarcinoma.
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PMID:Nephrogenic adenomas of the urethra involving the prostate gland: a report of two cases of a lesion that may be confused with prostatic adenocarcinoma. 136 96

Prostate-specific antigen (PSA) is increasingly used in the diagnosis of prostatic pathology. Its usefulness in the early diagnosis of prostatic cancer is controversial. The aim of the study is to evaluate the sensitivity and specificity of PSA in a population with prostate diseases. Moreover, we wanted to know if the measure of the prostate volume may increase the sensitivity of the test. In benign prostatic hypertrophy (88 patients), a good correlation exists between circulating PSA and the prostatic volume or the volume of the adenoma. This correlation disappears in the presence of an adenocarcinoma at the profit of the tumor volume (46 patients). Used as a means of screening for cancer, the serum level of PSA with a threshold value of 2.5 ng/ml has a sensitivity of 91% and a specificity of 32%. The sensitivity is 50% and the specificity is 85% at a level of 15 ng/ml. Taken alone, the level of PSA is inadequate for diagnosis: If the lower level is chosen (2.5 ng/ml), the majority of benign prostatic hypertrophies will be the object of a biopsy. If the higher level is chosen (15-23 ng/ml), 50% of localized cancers of the prostate will escape detection. Nevertheless, a level of PSA < 15 ng/ml is an argument for a strong suspicion in favor of an adenocarcinoma of the prostate. The capacity of BPH to "secrete" serum PSA is five times greater than that of the normal peripheral prostate, and the capacity of cancer is 20 times greater than that of an adenoma. The individual variability of serum PSA per cubic centimeter of prostatic tissue is too great to allow a precise interpretation as a function of volume.
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PMID:[Circulating prostatic-specific antigen in benign hypertrophy and localized prostate cancer: can PSA be considered a screening examination for localized cancer?]. 172 43

Metastases to the thyroid gland are an uncommon occurrence, and metastasis to a preexisting thyroid neoplasm is even more rare. We report two cases of tumor-to-tumor metastasis where a prostatic and a breast carcinoma metastasized to follicular adenoma of the thyroid gland. The metastatic process in case 1 was initially diagnosed by fine-needle aspiration biopsy and later confirmed with the hemithyroidectomy. Immunostaining for prostate-specific antigen and prostatic acid phosphatase in case 1 and estrogen and progesterone receptors in case 2 demonstrated strong immunoreactivity in the metastatic tumor cells. Flow cytometric DNA analysis of the primary and the metastatic tumors in both cases demonstrated stemline fidelity that supported their association. Our cases exemplify why attention should be given to the possibility of metastasis when distinctly different morphologic features are seen in an otherwise typical tumor and the utility of ancillary tests that may assist in establishing the diagnosis.
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PMID:Carcinomas metastatic to follicular adenomas of the thyroid gland. Report of two cases. 751 64

Prostatic basal cell proliferations range from focal basal cell hyperplasia (BCH) to florid adenoid basal cell tumor (ABCT). We reviewed 36 cases of basal cell proliferation to evaluate the architectural and cytologic spectrum of these lesions and identified four distinct patterns by light microscopy: BCH, 12 cases, including two cases with stromal sclerosis; atypical BCH with nucleolomegaly, eight cases; basal cell adenoma (BCA), nine cases; and ABCT, seven cases. Twenty-three cases were evaluated immunohistochemically, and all displayed cytoplasmic immunoreactivity in basal cells with basal-cell-specific high-molecular-weight keratin 34 beta E12 but with increased staining in BCH compared with that in BCA and ABCT. Prostate-specific antigen and prostatic acid phosphatase reactivity were seen at least focally in all cases except two cases each of BCA and ABCT. Chromogranin, S-100 protein, and neuron-specific enolase reactivity were rare or negative in all cases. Nucleolar diameter, measured in 18 of the 36 cases, was significantly greater in atypical BCH (mean, 1.96 microns) than in other forms of basal cell proliferation (mean, < 1.0 microns) (P < 0.05). These results indicate that on the basis of light microscopic, immunohistochemical, and morphometric findings, the spectrum of basal cell proliferations in the prostate can be separated into four distinct groups: BCH, atypical BCH, BCA, and ABCT.
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PMID:Atypical basal cell hyperplasia of the prostate. Immunophenotypic profile and proposed classification of basal cell proliferations. 768 48

Nineteen clear cell adenocarcinomas of the urethra, 18 from women and one from a man, are described. The patients ranged from 35 to 80 years of age (average, 58 yrs). The clinical presentation and gross findings were similar to those of urethral carcinomas, except that 12 tumors, all from women, arose within a urethral diverticulum. On microscopic examination, the neoplasms exhibited the classic triad of tubulocystic, papillary, and diffuse patterns that characterize this tumor. The tumors had the typical cytologic features of clear cell adenocarcinoma, including hobnail cells, flattened cells, and cells with abundant clear cytoplasm. Nuclear pleomorphism was typically at least moderate and was marked in almost half the specimens. Mitotic figures were easily found in almost all the specimens. These cytologic features should aid in distinction of this carcinoma from the benign nephrogenic adenoma, although one of our patients was initially misdiagnosed as having the latter. Immunostaining for prostate-specific antigen and prostatic acid phosphatase was performed on 13 tumors, and all were negative. Follow-up is available for 13 patients. Six of them had no evidence of recurrence up to 10 years postoperatively. Four patients died of disease from 5 months to 42 months postoperatively. Three additional patients have had recurrence but were alive up to 6.5 years after presentation. We conclude that urethral clear cell adenocarcinoma occurs in adults, and in women in the great majority of cases; has a particular association with a urethral diverticulum, which has been present in 56% of the patients; is indistinguishable from clear cell adenocarcinoma of the female genital tract but is not associated with endometriosis; probably does not arise by malignant transformation of nephrogenic adenoma; is usually readily distinguished from the latter because of greater cytologic atypicality and mitotic activity; and does not stain for prostate-specific antigen or prostatic acid phosphatase.
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PMID:Clear cell adenocarcinoma of the urethra: a clinicopathologic analysis of 19 cases. 873 66

Transurethral microwave thermotherapy (TUMT) is a single-session, 1-hour office-based treatment for benign prostatic hyperplasia. A randomized, double-blind study has been conducted at our institutions involving 115 patients who, after satisfying the entry criteria, were randomized in a 2:1 fashion to receive TUMT or a sham treatment. Three months' unblinding revealed both statistically and clinically significant improvement in the efficacy measures for the real treatment compared with the sham. The mean Madsen Symptom Score decreased 55% and the mean peak flow rate increased 58% in the TUMT-treated patients v 28% and 27% in the sham-treated patients (P < 0.001). Also, the TUMT-treated patients improved in mean AUA Symptom Score by 43% v 26% for sham-treated patients (P < 0.01). Reclassification of patients after therapy showed a greater shift to the mild category of AUA Symptom Score: 37% for TUMT patients v 6.5% for sham-treated patients. In addition, prostate-specific antigen elevation to >4 times baseline was noted 1 week after TUMT v no statistically significant change for sham-treated patients. This double-blind study demonstrates that thermotherapy's efficacy is not placebo related and that the mechanism of action is related to thermal ablation of transition zone adenoma.
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PMID:Transurethral microwave thermotherapy v sham treatment: double-blind randomized study. 897 94

Because of histological similarities between nephrogenic adenomas and clear cell adenocarcinomas of the urinary tract, there is the potential for diagnostic confusion between these two entities. The histopathologic features of 13 nephrogenic adenomas and five clear cell adenocarcinomas of the urethra and urinary bladder are compared in this report, and detailed immunohistochemical staining profiles are provided for these tumors. Only 2 of the 13 nephrogenic adenomas contained clear cells, and these constituted less than 10% of the lesions. In contrast, four of the five clear cell adenocarcinomas contained prominent areas with clear cells. Nephrogenic adenomas generally showed only mild cytologic atypia, whereas four of the five clear cell adenocarcinomas showed severe atypia. A single mitotic figure was identified in only two of the nephrogenic adenomas, whereas the mitotic rate in the clear cell adenocarcinomas ranged from 2 to 14 per 10 high-power fields. None of the nephrogenic adenomas showed evidence of necrosis, but focal necrosis was noted in four of the five clear cell adenocarcinomas. In general, the nephrogenic adenomas and clear cell adenocarcinomas showed negative to weak staining with CK903 but strong staining with AE1, AE3, and Cam 5.2. Variable staining was observed with Brst-3 and antibodies to S-100, CEA (monoclonal and polyclonal), LeuM-1, and CA19.9. Nephrogenic adenomas and clear cell adenocarcinomas were all negative for prostate-specific acid phosphatase (PSAP), prostate-specific antigen (PSA), and estrogen and progesterone receptors (except for two nephrogenic adenomas, which showed only focal weak staining for estrogen receptor). Neither bcl-2 nor c-erbB-2 staining was able to discriminate between the tumors. However, strong staining for p53 was noted in each clear cell adenocarcinoma and in none of the nephrogenic adenomas. MIB-1 positivity in nephrogenic adenomas ranged from 0 to 13 (average of 5.5) per 200 cells, whereas the positive range for clear cell adenocarcinomas was 33 to 70 (average of 47) per 200 cells. In summary, histopathologic features that favor clear cell adenocarcinoma over nephrogenic adenoma include a predominance of clear cells, severe cytological atypia, high mitotic rate, necrosis, high MIB-1 positivity, and strong staining for p53.
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PMID:Clear cell adenocarcinoma and nephrogenic adenoma of the urethra and urinary bladder: a histopathologic and immunohistochemical comparison. 986 32

Papillary adenoma of the prostatic urethra is a rare cause of hematuria, hemospermia and lower urinary tract obstruction, especially in young adults. We report two cases of papillary adenoma and their endoscopic views. One of the patients had a lesion located on the verumontanum and presented with hematuria, hemospermia and symptoms of lower urinary tract obstruction. The other patient had papillary lesions located in the paramontanal gutter and presented with persistent painless hematuria. The origin of both lesions was proven to be prostatic epithelial differentiation using immunohistochemical identification of prostate-specific antigen. Papillary adenoma is believed to be benign, therefore, both lesions were carefully excised and fulgurated transurethrally.
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PMID:Papillary adenoma of the prostatic urethra: report of two cases. 1288 71

Biopsy is the standard method for the diagnosis of prostate cancer; however, it is inadequate for the assessment of lymph node invasion. Radionuclide imaging might be useful for both diagnosis and N staging, but it requires high uptake of radiotracers in order to overcome difficulties arising from the anatomy of the region. The aim of this study was to assess whether or not technetium-99m labelled bombesin (99mTc-BN) scan is able to detect prostate cancer and invasion of pelvic lymph nodes. Ten patients were studied with 99mTc-BN, transrectal ultrasonography, biopsy, computed tomography and magnetic resonance imaging. All the patients with cancer were operated on. Planar dynamic scintigraphy and single-photon emission tomography (SPET) were performed after administration of 185 MBq 99mTc-BN. Two patients showed benign adenoma and eight showed cancer at biopsy. The average Gleason's score was 7.5+/-1.3. 99mTc-BN dynamic planar scan showed hot spots in the prostatic fossa in two of the eight patients with cancer, both of whom had a prostate-specific antigen level higher than 20 ng/ml. In these patients, high uptake inside the prostatic fossa was detected as early as 1 min after injection, before the arrival of radioactivity in the bladder. True positive SPET scans were obtained in all eight patients with cancer. Invasion of the obturator nodes was detected by SPET in three patients, and in all three was confirmed at surgery. Our preliminary data encourage further studies on the prostate with 99mTc-BN. If the high sensitivity of 99mTc-BN SPET is confirmed, this method may play an important role in diagnosing and staging prostate cancer.
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PMID:99mTc-bombesin detects prostate cancer and invasion of pelvic lymph nodes. 1292 Apr 85

Alpha-Methylacyl-CoA racemase (AMACR, P504S) has recently been shown to be a useful marker for the diagnosis of prostatic adenocarcinoma and a potential aid in its distinction from its many mimics, one of which is the benign lesion, nephrogenic adenoma (NA). The goal of this study was to assess the expression of AMACR in NA by immunohistochemistry, as well as other potentially useful markers, high-molecular-weight cytokeratin clone 34betaE12, p63, and prostate-specific antigen (PSA). AMACR was expressed in 4/4 NAs involving the prostatic urethra and underlying stroma, and in 3/16 NAs involving the bladder. The prostatic cases showed circumferential granular cytoplasmic AMACR expression of at least moderate intensity, in >75% of tubules in 3 cases and in <10% of tubules in the remaining case. The AMACR-positive cases in the bladder typically showed focal weak noncircumferential staining of the tubules and stronger staining of the cells lining the papillae. 34betaE12 staining was observed in 1/4 prostatic NAs and 4/16 bladder NAs, typically in a cytoplasmic pattern in a minority of cells. p63 and PSA were negative in all cases. Our data indicate that NA of the prostatic urethra commonly expresses AMACR and lacks basal cell-specific markers, making it not only a potential morphologic mimic of prostatic adenocarcinoma but also a significant immunohistochemical mimic as well. Awareness of NA as a significant pitfall in the diagnosis of prostatic adenocarcinoma and careful examination of hematoxylin and eosin-stained sections remains the key to the correct diagnosis, which can be supported by a negative PSA stain.
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PMID:Expression of alpha-methylacyl-CoA racemase (P504S) in nephrogenic adenoma: a significant immunohistochemical pitfall compounding the differential diagnosis with prostatic adenocarcinoma. 1609 17


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