摘要
目的总结前列腺尤文肉瘤/原始神经外胚层肿瘤的临床病理特征,并探讨分子检测在该肿瘤鉴别诊断中的意义。方法回顾分析1例确诊老年男性EWS/PNET及1例具有相似免疫表型的低分化前列腺癌的组织学、免疫组化、分子病理检测结果,结合文献总结前列腺EWS/PNET病理诊断要点。结果EWS/PNET多见于年轻人,偶见于老年人;肿瘤体积通常较大,血清PSA水平大多在正常范围;CD99弥漫膜阳性在EWS/PNET与低分化前列腺癌中均可出现,而且后者也可呈CD99与FLI-1联合阳性;利用RT-PCR方法在EWS/PNET中检出EWSR1-FLI-1的融合基因,而EWSR1分离探针在低分癌中阴性;EWS/PNET也可表达前列腺器官特异性标记AR、PSA。结论EWS/PNET发生于前列腺罕见,有可能与低分化前列腺癌相混淆,分子检测在鉴别诊断中具有参考意义。
Objective To sumerize the clinicopathological features of primitive neuroectodermal tumor/Ewing’S sarcoma(EWS/PNET)of the prostate and to explore the signifiance of molecular dection for differential diagnosis.Methods The results of morphology,immunochemistry and molecular test of an elderly patient with EWS/PNET were reviewed.A case of poorly differentiated prostate carcinoma(PC)with similar immuopnenotyping was also analyzed.The diangostic keys of EWS/PNET in prostate were sumerized based on above results and published literatures.Results EWS/PNET in the prostate,most of which had big volume and normal level of serum tPSA,occurred more frequently in young people,while rarely in elderly men.Diffuse expression of CD99 was always found in EWS/PNET and occasionally in poorly differentiated PC which could also have joint expression of CD99 and FLI-1.EWSR1-FLI-1 fusion gene was detected in EWS/PNET by RT-PCR,while break apart probe of EWSR1 was negative in poor differentiated PC by FISH.AR and PSA could also expressed in EWS/PNET of the prostate.Conclusion EWS/PNET,which may be confused with poorly differentiated PC,rarely occurs in the prostate.Molecular test is necessary for differential diagnosis.
作者
汤显斌
李丹
姚莉
郝颖华
陈修文
王代忠
袁玲玲
刘平
王铁延
TANG Xian-bin;LI Dan;YAO Li;HAO Ying-hua;CHEN Xiu-wen;WANG Dai-zhong;YUAN Ling-ling;LIU Ping;WANG Tie-yan(Department of Pathology,Taihe Hospital,Hubei University of Medicine,Shiyan 442000,China)
出处
《诊断病理学杂志》
2021年第11期903-907,912,共6页
Chinese Journal of Diagnostic Pathology
