前列腺非典型腺瘤样增生12例病理形态学观察  

Atypical adenomatous hyperplasia of prostate:a pathologic study of 12 cases

作　　者：赵红艳[1] 叶明福[2] 孙智才[1] 魏国红[1] 梅新明[1] 文显平[1] 梁智敏[1] 

机构地区：[1]解放军254医院病理科,天津300142 [2]第三军医大学新桥医院病理科,重庆400037

出　　处：《诊断病理学杂志》2011年第1期1-4,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨前列腺非典型腺瘤样增生(AAH)的病理形态学特征和鉴别诊断。方法收集AAH标本12例,应用光镜、免疫组化EliVisionTMPlus二步法,检测34βE12、p63、P504S、PSA和PSAP抗体,观察其病理形态和免疫组化特点。结果 12例AAH均来自良性前列腺增生手术切除标本,12例腺泡均呈结节状增生,增生的腺泡排列紊乱、结构完整,基底细胞难以辨别,需要与高分化腺癌的腺泡鉴别。其中8例由大小基本一致的中、小腺泡构成,4例腺泡大小不均;11例腺泡呈低乳头状结构,5例伴有前列腺萎缩后增生。免疫组化显示,增生的腺泡边缘34βE12或p63均呈(+),P504S均(-);其中5例基底细胞基本完整,7例断续存在。结论 AAH是较少见的前列腺瘤样病变,易误诊为前列腺高分化腺癌。基底细胞标记物34βE12、p63和癌性上皮标记物P504S联合应用对AAH的诊断具有实际应用价值。Purpose To investigate the histopathological features and differential diagnosis of atypical adenomatous hyperplasia（AAH）.Methods Twelve cases of AAH were investigated by hematoxylin-eosin and immunohistochemical stain（two-step ElivisionTM Plus method） to detect the expression of 34βE12,p63,P504S,PSA and PSAP.The pathological morphology and immunohistochemical features of of atypical adenomatous hyperplasia were studied.Results Twelve cases had been diagnosed as benign prostate hyperlasia and excised by radical prostatectomies,which were rediagnosed as AAH later.In all cases acini were nodularly hyperplased in a disarranged pattern with intact structure and uncertain basal cells,which made them necessary to be distinguished from carcinoma.In this study,moderate or small acini with almost same size were observed in 8 cases,and different size in the other 4 cases;and low papillary structure was obeserved in 11 of 12 cases,as well as postatrophic hyperplasia in 5 of 12 cases around the atypical adenomatous hyperplasia.By using immunohistochemical stain of 34βE12,p63 and P504S,almost intact basal cells were observed in 5 cases and partially intact basal cells in the other 7 cases around all hyperplastic acini.Conclusions AAH is an infrequent prosatate tumor-like lesion and tends to be misdiagnosed as prostate carcinoma.Basial cell markers（34βE12 and p63）combined with epithelial cell marker（P504S）are very useful in differential diagnosis of AAH from other prosate tumor-like lesions.

关 键 词：前列腺 非典型腺瘤样增生 病理学 免疫组化 

分 类 号：R737.25[医药卫生—肿瘤]