Clinicopathological features to distinguish malignant solitary fibrous tumors of the prostate from prostatic stromal tum
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ORIGINAL ARTICLE
Clinicopathological features to distinguish malignant solitary fibrous tumors of the prostate from prostatic stromal tumors Yuemei Xu 1,2 & Zhiwen Li 1 & Jiong Shi 1 & Yao Fu 1 & Li Zhu 3 & Xiangshan Fan 1 & Wen-Chi Foo 2 Received: 6 May 2020 / Revised: 27 July 2020 / Accepted: 10 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Mesenchymal tumors of the prostate are rare but encompass a wide differential diagnosis. In our study, we aimed to investigate the clinicopathological features that can be used to differentiate malignant solitary fibrous tumors (mSFTs) occurring in the prostate from prostatic stromal tumors. A total of 15 patients with mesenchymal tumors of the prostate were identified in Nanjing Drum Tower Hospital from 2009 to 2019, including 3 mSFTs, 9 stromal tumors of uncertain malignant potential (STUMPs), and 3 prostatic stromal sarcomas (PSSs). Immunohistochemical stains for signal transducer and activator of transcription 6 (STAT6), aldehyde dehydrogenase 1 (ALDH1), CD34, desmin, smooth muscle actin (SMA), progesterone receptor (PR), CD117, and cytokeratin (CK) were performed on representative sections from each tumor, and the clinical features, histology, and immunophenotype of these three groups were analyzed. There was no significant difference in mean patient age of patients diagnosed with mSFTs, STUMPs, and PSSs. mSFTs and PSSs showed significantly increased tumor size (p < 0.05), Ki-67 proliferation index (p < 0.0001), and mitotic activity (p < 0.05) when compared with STUMPs. mSFTs showed significantly higher expression of STAT6 compared with both PSSs and STUMPs (p < 0.0001, p < 0.0001). PR showed significantly more expression in STUMPs than in mSFTs or PSSs (p < 0.0001, p < 0.0001). Desmin and SMA showed significantly more expression in STUMPs than in mSFTs (p < 0.05). ALDH1, CD117, CK, and CD34 showed no significant difference in staining between mSFTs, STUMPs, and PSSs. Therefore, a limited panel of STAT6, PR, and Ki-67 may be useful in distinguishing between mSFTs, STUMPs, and PSSs. Keywords Solitary fibrous tumor . Malignant solitary fibrous tumor . Prostate . Stromal tumors of uncertain malignant potential . Prostatic stromal sarcomas . STAT6
Abbreviations ALDH1 Aldehyde dehydrogenase 1 CD Cluster of differentiation CK Cytokeratin GIST Gastrointestinal stromal tumor Xiangshan Fan and Wen-Chi Foo contributed equally to this work. * Wen-Chi Foo [email protected] 1
The Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road No. 321, Nanjing 210008, China
2
The Department of Pathology, Duke University School of Medicine, Durham, NC 27710, USA
3
The Department of Medical Imaging, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road No. 321, Nanjing 210008, China
HPF IHC PR PSS SFT SMA STAT6 STUMP WHO
High-power field Immunohistochemistry Progesterone receptor Prostatic stromal sarcoma Solitary fibrous t
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