Fine‐needle aspiration of metastatic prostatic neuroendocrine carcinomas: Cytomorphologic and immunophenotypic features

Abstract

Metastatic prostatic carcinoma may, in rare occasions, present as a neuroendocrine tumor. Its recognition is crucial to avert a wrongful exclusion of prostate as a primary site. We report five cases of metastatic prostatic neuroendocrine carcinoma diagnosed by image-guided fine-needle aspiration biopsy. The aspirate smears showed loosely cohesive or dyscohesive clusters of tumor cells with scanty (three cases) to moderate amount (two cases) of cytoplasm, speckled or coarse chromatin and inconspicuous nucleoli. Nuclear molding and necrosis were focally present in two cases. Immunohistochemically, the tumor cells were positive for synaptophysin or/and chromogranin, but negative for prostatic specific antigen and prostatic specific acid phosphatase. Review of prior prostate biopsies/resections revealed adenocarcinoma with focal neuroendocrine differentiation in all cases, with two cases being newly recognized on retrospective review. Confirming neuroendocrine differentiation in the prior biopsy/resection may help to establish a link between metastasis and prostate primary.

Lactate MRSI and DCE MRI as surrogate markers of prostate tumor aggressiveness

“…This enables one to avoid issues associated with xenograft models, which initially have a murine vascular system. Although the AT tumor shows significant necrosis (15–20% of the total tumor volume at volumes of 2000–2500 mm 3 ), which is not commonly seen in human tumors, reports of prostate tumor necrosis in patients, particularly in aggressive tumors, have been published . Although all tumor models are imperfect, the choice of these tumor models for the investigation of contrasting tumor properties is reasonable.…”

Metastatic Neuroendocrine Neoplasms of Unknown Primary: Clues from Pathology Workup

“…However, as current guidelines require histological assessment of the tumor tissue in order to properly grade a NEN, a core-needle biopsy is strongly recommended [6,15]. Indeed, even though the value of FNAB is not to be entirely neglected [16][17][18], the literature supports the use of CNB rather than FNAB when assessing NENs (both primary and metastatic) [19][20][21][22]. In CNB material, the Ki-67 index can usually be established by counting at least 2000 cells in hotspot areas, and other advantages include the possibility to perform immunohistochemistry to pinpoint the tumoral origin, a possible hormone production, the SSTR status, and potentially the PD-L1 status before considering eventual adjuvant treatment.…”