前列腺肉瘤19例临床病理分析

Prostate sarcoma:a report of 19 cases

目的探讨前列腺肉瘤(PS)的病理学诊断、组织学分类、鉴别诊断及发病率情况。方法收集解放军总医院1990—2008年间诊断的PS共19例,做常规HE及免疫组化染色,并复习文献。结果PS占同期前列腺恶性肿瘤的2.1%。发病年龄17～74岁,平均40.8岁。19例肉瘤中平滑肌肉瘤9例,横纹肌肉瘤6例,非霍奇金淋巴瘤(NHL)2例,恶性间质瘤1例,梭形细胞肉瘤1例。不同类型PS免疫组化染色各具其特征。结论前列腺肉瘤发病率很低,临床上主要表现为进行性排尿困难。影像学检查有助于发现前列腺占位性病变,确诊要靠前列腺穿刺活检组织学诊断,免疫组化染色有助于PS分类。本病恶性程度高,预后极差。

Objective To discuss the pathological features, histological classification, differential diagnosis and the incidence of the prostate sarcoma （PS）. Methods 19 cases of PS were collected from 1990 to 2008 in this hospital and observed by light microscopy and immunohistochemical technique with literature review. Results The PS was accounted for 2. 1% of all the prostatic malignant tumors. The average age was 40. 8 years old （ranged from 17 to 74 years）. Among of the 19 cases, 9 were leiomyosarcoma, 6 rhabdomyosarcoma, 2 non Hodgking lymphoma （ NHL）, 1 malignant stromal tumor and 1 spindle cell sarcoma. Different PS had its own immunohistochemical features. Conclusions The PS is rare and dysuria always is the first symptoms. Ultrosound, CT and MRI examinations are helpfull to find this tumor. Needle biopsy contributes to a definite diagnosis and the immunohistochemical staining helps for the classification of the disease. This tumor is a high malignancy with very poor prognosis.