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目的探讨前列腺腺癌合并睾丸鞘膜高分化乳头状间皮瘤(WDPM)的临床病理特点、免疫组化、诊断与鉴别诊断要点。方法分析1例前列腺腺癌合并睾丸鞘膜WDPM的临床病理资料、组织学及免疫组化特征,并复习相关文献。结果患者第一次因术前诊断为前列腺增生而行经尿道前列腺电切手术,病理诊断为前列腺腺癌。术后20天再次入院行双侧睾丸切除术。在左侧睾丸鞘膜偶然发现2个灰白色绒毛样赘生物,镜下肿瘤由乳头状结构组成,乳头中心为纤维血管轴心伴间质透明变性,表面被覆单层轻微扁平至立方状的上皮样细胞,异型性小。免疫组化示AE1/AE3、calretinin、vimentin、CK5/6和HMBE-1(+),p63、PSA、PSAP和CEA(-)。结论睾丸鞘膜高分化乳头状间皮瘤和前列腺腺癌并发极为罕见,可被误诊为前列腺腺癌伴睾丸鞘膜癌转移,加深对此肿瘤组织学和免疫组化染色特征的认识有助于正确诊断与鉴别诊断。
Objective To investigate the clinicopathologic characteristics, immunohistochemical diagnosis, and differential diagnosis of prostatic adenocarcinoma with papillary duodenal papilla mesothelioma (WDPM). Methods The clinicopathological, histological and immunohistochemical features of 1 case of prostatic adenocarcinoma combined with testicular sheath WDPM were analyzed. The related literatures were reviewed. Results For the first time because of preoperative diagnosis of benign prostatic hyperplasia and transurethral resection of prostate, the pathological diagnosis of prostate cancer. 20 days after admission again hospital bilateral orchidectomy. In the left testis sheath accidentally found two gray villous neoplasms, microscopic tumor by the papillary structure, the center of the nipple fibrosis axis with interstitial transparent degeneration, the surface of the monolayer slightly flattened to cubic epithelial Cells, atypia small. Immunohistochemistry showed AE1 / AE3, calretinin, vimentin, CK5 / 6 and HMBE-1 (+), p63, PSA, PSAP and CEA (-). Conclusions Hypoechoic papillary mesothelioma and prostatic adenocarcinoma are extremely rare and may be misdiagnosed as metastatic prostatic adenocarcinoma with testis and hydrocephalus. It would be helpful to understand the histological and immunohistochemical characteristics of this tumor Correct diagnosis and differential diagnosis.