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Presented by Dr. Matoso and prepared by Daniel Miller
This is a TURP from a 65 year-old gentleman.
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Question 1 of 1
1. Question
This is a TURP from a 65 year-old gentleman.
Choose the correct diagnosis.
Correct
Answer: C. Basal cell carcinoma
Histology: Nests of tumor cells arranged in an adenoid cystic pattern. Cells have small nuclei with inconspicuous nucleoli and scant cytoplasm. There is palisading towards the periphery of the nests and the center show cells with eosinophilic cytoplasm.
Discussion: Basal cell hyperplasia of the prostate can be difficult to differentiate from basal cell carcinoma. Adenoid cystic pattern, as seen in this case, is pathognomonic of basal cell carcinoma. Other features characteristic of basal cell carcinoma but not hyperplasia include necrosis, anastomosing basaloid nests and tubules centrally lined by eosinophilic cells, variably sized nests with irregular shapes, extension into thick muscle bundles, stromal response, strong and diffuse Bcl-2 staining and Ki67 labeling index >20%. Only a small subset of basal cell carcinoma behaves aggressively.
Reference(s):
-Hum Pathol. 2015 Jun;46(6):805-12. doi: 10.1016/j.humpath.2015.02.004. Epub 2015 Feb 26.Incorrect
Answer: C. Basal cell carcinoma
Histology: Nests of tumor cells arranged in an adenoid cystic pattern. Cells have small nuclei with inconspicuous nucleoli and scant cytoplasm. There is palisading towards the periphery of the nests and the center show cells with eosinophilic cytoplasm.
Discussion: Basal cell hyperplasia of the prostate can be difficult to differentiate from basal cell carcinoma. Adenoid cystic pattern, as seen in this case, is pathognomonic of basal cell carcinoma. Other features characteristic of basal cell carcinoma but not hyperplasia include necrosis, anastomosing basaloid nests and tubules centrally lined by eosinophilic cells, variably sized nests with irregular shapes, extension into thick muscle bundles, stromal response, strong and diffuse Bcl-2 staining and Ki67 labeling index >20%. Only a small subset of basal cell carcinoma behaves aggressively.
Reference(s):
-Hum Pathol. 2015 Jun;46(6):805-12. doi: 10.1016/j.humpath.2015.02.004. Epub 2015 Feb 26.
