Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1519176 (PSA)
 5,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prostatic adenocarcinoma and urothelial carcinoma (transitional cell carcinoma) may coexist in the prostate. However, a carcinoma with mixed features has not been recognized. Four cases, three surgical pathology cases and one autopsy case of prostatic adenocarcinoma with urothelial carcinoma features, were retrospectively found in a urological pathology teaching file maintained from 1984 to 1993. Subsequently, 181 consecutive cases of radical prostatectomy from 1994 to 1999 were reviewed, and two prostatic adenocarcinoma areas with features of urothelial carcinoma were identified. Areas with urothelial carcinoma features were identified in the intraductal component of the carcinoma in five cases and in the invasive component in three cases. The intraductal carcinoma with urothelial carcinoma areas usually merged with regions of prostatic adenocarcinoma with a papillary or cribriform pattern. All prostatic adenocarcinomas having areas with urothelial carcinoma features were of high stage, and five of six cases had ductal features. The urothelial carcinoma component displayed a positive reactivity for thrombomodulin and negative or weaker reactivity for PAP and PSA than the prostatic adenocarcinoma component in the same tumor. Excluding the case noted at autopsy, all patients died of the disease within 3 years. Urothelial carcinoma features were usually associated with ductal carcinoma of high stage. Areas of prostatic adenocarcinoma with urothelial carcinoma features should be considered histopathologically as areas of mixed carcinoma of the prostate. Prostatic adenocarcinoma with areas of urothelial carcinoma features may pose a difficult differential diagnosis problem with urothelial carcinoma, especially with small biopsies with focal weak immunoreactivity for PAP, PSA, and thrombomodulin.
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PMID:Prostatic adenocarcinoma with urothelial (transitional cell) carcinoma features. 1237 49

For primary bladder tumors, distinguishing urothelial carcinoma (UC) invading the fibromuscular stroma of the prostate (pT4a) from in situ UC involving prostatic ducts can be difficult. Immunohistochemical markers (cytokeratin [CK]5/6, CK5, CK7, CK20, p53, p63, high-molecular-weight keratin [HMWK], androgen receptor, prostate-specific antigen [PSA], prostate specific acid phosphatase [PSAP], laminin, CD44s, CD141) were assessed for their usefulness in determining depth of UC invasion in the prostate. In cystoprostatectomy specimens containing in situ UC in prostatic ducts, both CK5/6 and CK5 clearly differentiated prostatic basal cells from in situ UC. The remaining markers were not effective in determining depth of tumor invasion. Double-stain combinations CK7/CK5 and p53/CK5 were performed and robustly color contrasted in situ tumor from surrounding basal cells. The use of CK5/6, CK5, CK7/CK5, or p53/CK5 is recommended to assist in determining the depth of UC invasion in the prostate when histologic findings are equivocal.
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PMID:CK5, CK5/6, and double-stains CK7/CK5 and p53/CK5 discriminate in situ vs invasive urothelial cancer in the prostate. 2290 29

High-grade prostate adenocarcinoma can have overlapping morphologic features with high-grade urothelial carcinoma, a critical distinction as treatments differ substantially. Pseudopapillary features have not previously been described in high-grade acinar prostate adenocarcinoma. We reviewed our consult cases (2006 to 2013) for cases of high-grade prostate adenocarcinoma, in which the Gleason score was equal to 5+4=9 or 5+5=10, and the differential diagnosis included high-grade urothelial carcinoma. We identified 7 consult cases of high-grade prostate adenocarcinoma with pseudopapillary features, mimicking urothelial carcinoma. Three cases were originally misdiagnosed as urothelial carcinoma. In 3 cases, the outside diagnosis was urothelial carcinoma versus prostate adenocarcinoma, and 1 case had no submitting diagnosis. All cases were transurethral resections, with tumor involving the prostatic urethra in 5 cases and 6 with bladder involvement. Three patients had a known history of prostate adenocarcinoma. The tumors grew in nests and sheets, 1 with microacinar differentiation and another with focal, rare glands. In places, tumors formed papillary-appearing structures with central blood vessels. In most cases, the nuclei were uniform with prominent nucleoli. One case had pleomorphic giant cell features, and another had sarcomatoid features. Necrosis was present in 2 cases. One case had a separate focus of low-grade noninvasive urothelial carcinoma present in the bladder and a better-differentiated prostate adenocarcinoma (Gleason score 4+3=7) involving the prostate on needle biopsy. In all cases, the pseudopapillary areas showed negative immunohistochemical staining for bladder markers including GATA3 (5 cases), p63 (5 cases), CK903 (4 cases), and thrombomodulin (3 cases). All cases showed positivity for prostatic markers including PSA (5 cases), p501s (6 cases), PSMA (4 cases), and NKX3.1 (5 cases). One case showed focal, nonspecific staining for p63, and another showed focal staining for p63 and CK903 in an area with squamous differentiation, contributing to the diagnostic difficulty. In summary, high-grade prostate adenocarcinoma can present in the urinary bladder and prostatic urethra, clinically mimicking urothelial carcinoma. Although high-grade prostate adenocarcinoma typically has relatively uniform cytology, it can have pleomorphic giant cell features overlapping with urothelial carcinoma. The presence of pseudopapillary features in high-grade prostate adenocarcinoma is a newly recognized morphologic overlap that can lead to further diagnostic difficulty in distinguishing the 2 entities. For high-grade tumors involving the prostatic urethra without typical admixed lower-grade prostate adenocarcinoma, immunohistochemical studies for bladder and prostate markers should be carried out.
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PMID:Pseudopapillary features in prostatic adenocarcinoma mimicking urothelial carcinoma: a diagnostic pitfall. 2450 58