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lymphoepithelioma-like prostatic adenocarcinoma
Tuesday 31 July 2012
These very rare, poorly differentiated carcinomas histologically resemble lymphoepitheliomas of the nasopharynx, but do not appear to be related to Epstein–Barr virus infection.
Only a few cases have been reported in the prostate.
Patients of a mean age of 76 years (range 69–82 years) present with obstructive symptoms, elevated serum PSA level, and locally advanced disease.
Microscopically, there is a syncytial growth pattern of carcinoma cells with indistinct cell borders.
A dense lymphocytic infiltrate is present, admixed with plasma cells and neutrophils, and, in one case, eosinophils.
The carcinoma cells are positive for PSA, PSAP, and AMACR. Admixed acinar adenocarcinoma is found in all cases; the lymphoepithelioma-like component ranges from 10% to 90% of the tumour.
The clinical outcome is poor: in one series, all patients died of the cancer at 8–26 months after diagnosis.
References
Histological variants of prostatic carcinoma and their significance. Humphrey PA. Histopathology. 2012 Jan;60(1):59-74. PMID: 22212078
