前列腺非上皮性肿瘤及瘤样病变的病理观察

Pathological observation of 16 cases with non-epithelial tumor and tumor-like lesions of the prostate

目的 探讨前列腺非上皮性肿瘤的诊断和鉴别诊断并观察其预后。方法 收集临床及病理资料 ,应用HE、免疫组织化学LSAB法及电镜等方法 ,对 16例前列腺非上皮性肿瘤的临床和形态特点进行了观察 ,并进行了随访。结果 16例中诊断前列腺间质结节 6例 ,前列腺恶性分叶状肿瘤 1例 ,前列腺间质肉瘤 3例 ,前列腺平滑肌肉瘤 3例 ,纤维肉瘤 1例 ,前列腺非霍奇金恶性淋巴瘤 2例。结论 伴发于前列腺良性增生过去诊断为前列腺平滑肌瘤的病变实为前列腺的间质结节。在穿刺的标本中 ,前列腺叶状囊肉瘤易与前列腺间质肉瘤混淆 ,前列腺间质肉瘤以无特定结构的小梭形细胞为特点。前列腺平滑肌肉瘤、纤维肉瘤、前列腺非霍奇金恶性淋巴瘤与软组织同类肿瘤的诊断标准相同。

Objective To investigate the diagnosis, differential diagnosis and prognosis of stromal tumors and tumor like lesions of the prostate. Methods By means of HE, immunohistochemistry and electron microscopy, the clinical and histological data of 16 cases with stromal tumors and tumor like lesions of the prostate were observed. Some of them were followed up. Results Of the 16 cases, 6 presented stromal nodular hyperplasia, 3 were stromal sarcoma, 1 malignant phyllodes type tumor, 3 leiomyosarcoma, 1 fibrosarcoma, and one non Hodgkin′s lymphoma. Conclusions Nearly all the leiomyomas of the prostate diagnosed previously are, in fact, stromal nodular hyperplasia. The phyllodes type tumors are often confused with stromal sarcomas in needle biopsy specimens and cause difficulty in differential diagnosis. Diagnostic criteria of leiomyosarcoma, fibrosarcoma, non Hodgkin′s lymphoma of the prostate are the same as their counterparts in the soft tissue. Non epithelial malignant tumors in prostate are of poor prognosis.