Difference between revisions of "Small cell carcinoma of the prostate gland"

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#redirect [[Prostate_cancer#Small_cell_carcinoma_of_the_prostate_gland]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Prostate carcinoma with NEC -- high mag.jpg
| Width      =
| Caption    = Small cell carcinoma of the prostate. [[H&E stain]].
| Synonyms  =
| Micro      = small cells with nuclear moulding, stippled chromatin and high [[NC ratio]], +/-high-grade acinar adenocarcinoma (common)
| Subtypes  =
| LMDDx      = [[small cell carcinoma of the urinary bladder]], metastatic [[small cell carcinoma]], poorly differentiated [[prostate carcinoma]]
| Stains    =
| IHC        = chromogranin A +ve, PSA -ve/+ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  = [[prostate biopsy]], [[prostate chips]], [[radical prostatectomy]]
| Staging    = [[prostate cancer staging]]
| Site      = [[prostate gland]] - see ''[[prostate cancer]]''
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  = [[PSA]] low (in relation to conventional cancer)
| Rads      =
| Endoscopy  =
| Prognosis  = poor
| Other      =
| ClinDDx    = other types of [[prostate cancer]], metastatic cancer
| Tx        = chemotherapy
}}
'''Small cell carcinoma of the prostate gland''' is a rare type of [[prostate cancer]] with an aggressive course.
 
The more general topic of ''[[prostate cancer with neuroendocrine differentiation]]'' is dealt with in a separate article.
 
==General==
*Very rare.<ref name=pmid22110988>{{Cite journal  | last1 = Furtado | first1 = P. | last2 = Lima | first2 = MV. | last3 = Nogueira | first3 = C. | last4 = Franco | first4 = M. | last5 = Tavora | first5 = F. | title = Review of small cell carcinomas of the prostate. | journal = Prostate Cancer | volume = 2011 | issue =  | pages = 543272 | month =  | year = 2011 | doi = 10.1155/2011/543272 | PMID = 22110988 }}</ref>
*Most common small cell carcinoma outside of the lung.<ref name=pmid22110988/>
*Poor prognosis.
*Not [[prostate cancer grading|graded]] ([[ISUP]] 2005 consensus on [[Gleason grading system]]<ref name=pmid16096414>{{Cite journal  | last1 = Epstein | first1 = JI. | last2 = Allsbrook | first2 = WC. | last3 = Amin | first3 = MB. | last4 = Egevad | first4 = LL. | title = The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. | journal = Am J Surg Pathol | volume = 29 | issue = 9 | pages = 1228-42 | month = Sep | year = 2005 | doi =  | PMID = 16096414 }}</ref>).
 
Clinical:
*PSA often low in comparison to conventional prostate cancer.<ref name=pmid22110988/>
 
==Microscopic==
Features:
*Small cells with:
**Nuclear moulding.
**Stippled chromatin.
**High [[NC ratio]].
*+/-High-grade acinar adenocarcinoma, i.e. conventional prostate carcinoma, seen in ~50% of cases.<ref name=pmid22110988/>
 
Notes:
*Similar to [[small cell carcinoma of the lung]].
*High-grade squamoid component favours metastatic [[urothelial carcinoma]].
**UCC usu. HWCK +ve.
 
DDx:
*[[Small cell carcinoma of the urinary bladder]].
*[[Lymphoma]], large cell.
*[[Prostate carcinoma with amphicrine features]] - also have [[AR]] staining.<ref name=pmid28756619>{{Cite journal  | last1 = Prendeville | first1 = S. | last2 = Al-Bozom | first2 = I. | last3 = Compérat | first3 = E. | last4 = Sweet | first4 = J. | last5 = Evans | first5 = AJ. | last6 = Ben-Gashir | first6 = M. | last7 = Mete | first7 = O. | last8 = van der Kwast | first8 = TH. | last9 = Downes | first9 = MR. | title = Prostate carcinoma with amphicrine features: further refining the spectrum of neuroendocrine differentiation in tumours of primary prostatic origin? | journal = Histopathology | volume = 71 | issue = 6 | pages = 926-933 | month = Dec | year = 2017 | doi = 10.1111/his.13330 | PMID = 28756619 }}</ref>
*Other [[small round cell tumours]].
 
===Images===
====Case====
<gallery>
Image: Prostate carcinoma with NEC -- very low mag.jpg | PCNEC - very low mag. (WC)
Image: Prostate carcinoma with NEC -- low mag.jpg | PCNEC - low mag. (WC)
Image: Prostate carcinoma with NEC -- intermed mag.jpg | PCNEC - intermed. mag. (WC)
Image: Prostate carcinoma with NEC -- high mag.jpg | PCNEC - high mag. (WC)
 
Image: Prostate carcinoma with NEC - conv only -- low mag.jpg | PCNEC - low mag. (WC)
Image: Prostate carcinoma with NEC - conv only -- intermed mag.jpg | PCNEC - intermed. mag. (WC)
Image: Prostate carcinoma with NEC - conv only -- high mag.jpg | PCNEC - high mag. (WC)
</gallery>
====www====
*[http://www.webpathology.com/image.asp?case=23&n=25 SmCC of the prostate - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?case=23&n=26 SmCC of the prostate - high mag. (webpathology.com)].
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200299/figure/fig1/ SmCC of the prostate - low mag. (nih.gov)].
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200299/figure/fig3/ SmCC of the prostate - high mag. (nih.gov)].
 
==IHC==
Features:<ref name=pmid22110988/>
*PSA weak +ve/-ve.
*Chromogranin +ve.
 
==See also==
*[[Prostate cancer]].
*[[Small cell carcinoma]].
*[[Paneth cell-like change of the prostate gland]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Prostate carcinoma]]

Latest revision as of 16:33, 19 March 2018

Small cell carcinoma of the prostate gland
Diagnosis in short

Small cell carcinoma of the prostate. H&E stain.
LM small cells with nuclear moulding, stippled chromatin and high NC ratio, +/-high-grade acinar adenocarcinoma (common)
LM DDx small cell carcinoma of the urinary bladder, metastatic small cell carcinoma, poorly differentiated prostate carcinoma
IHC chromogranin A +ve, PSA -ve/+ve
Grossing notes prostate biopsy, prostate chips, radical prostatectomy
Staging prostate cancer staging
Site prostate gland - see prostate cancer
Prevalence rare
Blood work PSA low (in relation to conventional cancer)
Prognosis poor
Clin. DDx other types of prostate cancer, metastatic cancer
Treatment chemotherapy

Small cell carcinoma of the prostate gland is a rare type of prostate cancer with an aggressive course.

The more general topic of prostate cancer with neuroendocrine differentiation is dealt with in a separate article.

General

Clinical:

  • PSA often low in comparison to conventional prostate cancer.[1]

Microscopic

Features:

  • Small cells with:
    • Nuclear moulding.
    • Stippled chromatin.
    • High NC ratio.
  • +/-High-grade acinar adenocarcinoma, i.e. conventional prostate carcinoma, seen in ~50% of cases.[1]

Notes:

DDx:

Images

Case

  • PCNEC - very low mag. (WC)

  • PCNEC - low mag. (WC)

  • PCNEC - intermed. mag. (WC)

  • PCNEC - high mag. (WC)

  • PCNEC - low mag. (WC)

  • PCNEC - intermed. mag. (WC)

  • PCNEC - high mag. (WC)

www

IHC

Features:[1]

  • PSA weak +ve/-ve.
  • Chromogranin +ve.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Furtado, P.; Lima, MV.; Nogueira, C.; Franco, M.; Tavora, F. (2011). "Review of small cell carcinomas of the prostate.". Prostate Cancer 2011: 543272. doi:10.1155/2011/543272. PMID 22110988.
  2. ↑ Epstein, JI.; Allsbrook, WC.; Amin, MB.; Egevad, LL. (Sep 2005). "The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma.". Am J Surg Pathol 29 (9): 1228-42. PMID 16096414.
  3. ↑ Prendeville, S.; Al-Bozom, I.; Compérat, E.; Sweet, J.; Evans, AJ.; Ben-Gashir, M.; Mete, O.; van der Kwast, TH. et al. (Dec 2017). "Prostate carcinoma with amphicrine features: further refining the spectrum of neuroendocrine differentiation in tumours of primary prostatic origin?". Histopathology 71 (6): 926-933. doi:10.1111/his.13330. PMID 28756619.
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