前列腺叶状肿瘤临床病理观察

Phyllodes tumor of the prostate:a clinicopathologic observation

目的探讨前列腺叶状肿瘤（PT）的临床病理特点,提高对该病的认识。方法报告2例前列腺PT,结合文献分析其临床表现、病理特征和免疫组化表达。结果前列腺PT由上皮和间叶成分组成,上皮细胞增生,无异型性,由上皮细胞形成的囊腔被增多的间质成分挤压形成类似叶状的裂隙。例1,间质细胞轻—中度异型,核分裂1-2/10 HPF,无坏死;例2,间质细胞异型性明显,核分裂〉5/10 HPF,有坏死。免疫组化染色上皮细胞CK、EMA和PSA均（＋）,间质细胞Vim（＋）,PR弱（＋）,部分间质细胞SMA（＋）。例1术后1年复发。结论前列腺PT罕见,可分为良性、交界性、恶性3种类型。该肿瘤易复发和转移,恶性者预后差。

Objective To study the clinical and pathological features of phyllodes tumor of the prostate. Methods Two cases of phyllades tumor of the prostate were reported with their clinical data, pathological features and immunohistochemical findings were analyzed with review of the literature. Results The pathology showed a special type of epithelial-stromal tumor. The epithelial cells proliferated but with no atypia, The tumor was composed of cystically dilated ducts with leaf-like stroma projections in the lumen. In case one, the stromal ceils proliferated with hght to moderate degree of cytological atypia, and it had no necrosis and mitotic rate 1-2/10 HPF. In case two, the stromal cells proliferated with obvious atypia, and it had necrosis and mitotic rate 〉 5/10 HPF. With immunohistochemical staining, the epithelial cells were positive for CK, EMA and PSA, and the stromal cells were positive for Vim and PR. Some of the stromal cells were positive for SMA. Case one had tumor recurrence after one year. Conclusions Phyllodes tumor of the prostate is rare. It can be classified into three types： benign, berderline and malignant. The tumor is easily to recur and metastasize. The prognosis of malignant type is poor.