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目的探讨前列腺恶性叶状肿瘤伴胚胎性横纹肌肉瘤样分化(MPTERD)的临床病理学特征。方法报告1例前列腺MPTERD,结合文献分析其临床特征、病理特征和免疫组化。结果患者男性,40岁。排尿困难2月余。前列腺肿瘤组织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。间质细胞异型性明显,核分裂>21个/10 HPF,有坏死。另外,局部还伴有胚胎性横纹肌肉瘤样分化。免疫组化:上皮细胞AE1/AE3(+),PSA局部(+);间质细胞vimentin(+),局部间质细胞desmin、myogenin(+),SMA、H-caldesmon、CD34和PR均(-)。结论前列腺MPTERD罕见,该肿瘤易复发和转移,预后差。
Objective To investigate the clinicopathological features of malignant leaf tumor of the prostate with embryonal rhabdomyosarcoma-like differentiation (MPTERD). Methods One case of MPTERD was reported and its clinical characteristics, pathological features and immunohistochemistry were analyzed. Results Patients Male, 40 years old. Dysuria more than two months. Prostate tumor tissue consists of epithelial and mesenchyme components, epithelial cells hyperplasia, atypia, the cysts formed by the epithelial cells are squeezed by the increased interstitial components to form leaf-like fissures. Interstitial cell atypia was obvious, mitotic> 21/10 HPF, with necrosis. In addition, some also accompanied by embryonic rhabdomyosarcoma-like differentiation. Immunohistochemistry: Epithelial cells AE1 / AE3 (+), PSA local (+); interstitial vimentin (+), local stromal cells desmin, myogenin (+), SMA, H-caldesmon, CD34 and PR ). Conclusion Prostate MPTERD rare, the tumor is easy to recurrence and metastasis, the prognosis is poor.