简介:印戒细胞通常与粘蛋白分泌上皮相关;因此,它们最常见于胃肠道,但不是唯一的。原发性前列腺印戒细胞癌是一种罕见的低分化,侵袭性腺泡腺癌变异体,预后严峻。临床病例:2023年6月,一名54岁的白种人男性主诉下尿路阻塞性症状,偶有巨大血尿,非特异性身体疼痛,呼吸急促.将在经尿道前列腺切除术中获得的前列腺标本送去进行组织病理学检查。经过一系列的前列腺外诊断检查,包括纤维胃十二指肠镜检查,结肠镜检查计算机断层扫描成像,和免疫组织化学研究,患者被诊断为原发性前列腺印戒细胞腺癌IV期.不幸的是,由于疾病的晚期,PE,和三度血小板减少症,该患者不是化疗的候选人,并在该周晚些时候死于心肺功能不全.讨论:前列腺印戒细胞癌占所有前列腺腺癌病例的0.02%。由于其性质和流行病学,必须进行勤奋的前列腺外调查。该疾病通常表现为不显著的临床症状和可变的血清前列腺特异性抗原结果,这可能有助于其晚期诊断。不一致的免疫组织化学结果和对激素治疗的不可预测的反应共同构成了对预后产生负面影响的诊断和治疗挑战。结论:本研究强调了多学科方法的重要性,以及在寻找疾病的主要部位时,研究界需要达成诊断和治疗共识。这可能会对预后产生积极影响。
Introduction: Signet-ring cells are typically associated with mucin-secreting epithelium; thus, they are most commonly found in the gastrointestinal tract, but not exclusively. Primary signet-ring cell carcinoma of the
prostate is a rare and poorly differentiated, aggressive acinar adenocarcinoma variant with a grim prognosis. Clinical
Case: In June of 2023, a 54-year-old Caucasian male presented with a complaint of lower urinary tract obstructive symptoms with occasional macrohematuria, non-specific body aches, and shortness of breath. A
prostate specimen obtained in transurethral resection of the
prostate was sent for histopathological examination. After a series of extraprostatic diagnostic workups, including fibrogastroduodenoscopy, colonoscopy computed tomography imaging, and immunohistochemical studies, the patient was diagnosed with primary prostatic signet-ring cell adenocarcinoma stage IV. Unfortunately, due to the advanced stage of the disease, PE, and third-degree thrombocytopenia, the patient was not a candidate for chemotherapy and died of cardiopulmonary insufficiency later that week. Discussion: Prostatic signet-ring cell carcinoma accounts for 0.02% of all
prostate adenocarcinoma cases. Due to its nature and epidemiology, a diligent extraprostatic investigation has to be carried out. The disease often presents with unremarkable clinical symptoms and variable serum
prostate-specific antigen results, which may contribute to its late diagnosis. Inconsistent immunohistochemical findings and an unpredictable response to hormonal treatment together pose both diagnostic and therapeutic challenges that negatively affect the prognosis. Conclusions: This study highlights the importance of a multidisciplinary approach and the need for diagnostic and therapeutic consensus within the research community in search of the primary site of the disease, which may positively influence the prognosis.