前列腺基底细胞增生的形态学观察

MORPHOLOGIC PATTERNS OF THE PROSTATIC BASAL CELL HYPERPLASIA

目的认识前列腺基底细胞增生形态学的多样化,提高前列腺病变的诊断与鉴别诊断水平。方法回顾1998年至2001年华东医院病理科20例前列腺基底细胞增生病例,描述其形态学特征并与高级别上皮内瘤、前列腺癌比较,同时作基底细胞特异性标记34βE12、及PSA、PAP免疫组化染色。结果4例形成界限清楚的结节,16例呈散在分布。结构上可呈实心巢状、腺状、鳞化、筛状,往往混合存在。另见腔内伊红色分泌物(3例)、微蓝色粘液(4例)、显著核仁(5例)、少量分裂相(2例)。未见腔内类结晶体、嗜双色胞质、核增大、染色质增加。34βE12显示连续而多层的强阳性。PSA、PAP染色阴性。结论基底细胞增生的某些形态与高级别上皮内瘤、前列腺癌相似而需鉴别诊断,34βE12有重要的辅助诊断价值。

Objective To recognize the morphologic varieties of prostatic basal cell hyperplasia(BCH) in order to facilitate the diagnosis and differential diagnosis of prostate lesions. Methods 20 cases of BCH between 1998 and 2001 in the department of pathology of Huadong Hospital were reviewed, their morphologic features were described and compared with high grade prostatic intraepithelial neoplasm(HGPIN) and adenocarcinoma, immunoperoxidase stains for basal cell specific antibody CK34βE12 , and PSA, PAP were also performed. Results 4 cases of BCH were present as distinct nodules, whereas 16 cases as diffused distribution. Histologic features demonstrated solid nests, glands, squamous metaplasia and cribriforms, often with admixed growth patterns. There were pink intraluminal secretions(in 3 cases), wispy blue mucin(in 4 cases), prominent nucleoli( in 5 cases), mitotic figures( in 2 cases). No intraluminal crystalloids, amphophilic cytoplasm, nuclear enlargement, hyperchromasia were observed. CK34βE12 showed continuous and multilayered intensive staining. PSA, PAP were negative. Conclusions Some morphologic patterns of BCH which closely mimic HGPIN,and adenocarcinoma should be differentiated. Staining with CK34βE12 has important value in ancillary diagnosis.