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Abstract：
The 2016 World Health Organization classification of prostate cancer with neuroendocrine (NE) differentiation includes NE cells in usual prostate cancer, adenocarcinoma with Paneth cell-like NE differentiation, well-differentiated NE tumor (carcinoid), small cell NE carcinoma, and large cell NE carcinoma. In this article, we report a rare case of primary prostatic carcinoma with de novo diffuse NE differentiation presenting with bilateral hydronephrosis in a 79-year-old man. This case did not fit into any of the existing classifications. The clinical, radiological, morphological, and immunohistochemical findings and response to androgen deprivation therapy (ADT) are presented. The proposed pathogenesis of NE differentiation via transdifferentiation from conventional prostatic adenocarcinoma whereby genomic alterations, coupled with ADT can induce lineage plasticity resulting in NE differentiation is described.
摘要：
2016年世界卫生组织对具有神经内分泌（NE）分化的前列腺癌的分类包括通常前列腺癌中的NE细胞，伴有潘氏细胞样NE分化的腺癌，高分化NE肿瘤（类癌），小细胞NE癌，和大细胞NE癌。在这篇文章中,我们报道了一例79岁男性原发性前列腺癌伴弥漫性NE从头分化伴双侧肾积水的罕见病例。此案不适合任何现有分类。临床，放射学,形态学,并介绍了免疫组织化学结果和对雄激素剥夺治疗（ADT）的反应。通过常规前列腺腺癌的转分化而提出的NE分化的发病机制，其中基因组改变，结合ADT可以诱导谱系可塑性，导致NE分化。
