前立腺印環細胞癌の1例

Abstract

76歳男.主訴は排尿困難.前立腺に硬結を認め, PASが高値を示し, 経会陰的前立腺針生検術を施行したところ, 病理組織学的診断は印環細胞癌, Gleason score 5+4であった.骨盤部MRIのT2強調像において前立腺の右葉外腺領域を中心としてlow intensityを示す腫瘤性病変を認め, 前立腺癌が疑われた.前立腺の正中部背側には嚢胞性病変を認めた.前立腺原発の印環細胞癌T2bN0M0, stage B2と診断し, 膀胱前立腺全摘除術, 骨盤内リンパ節郭清術, 回腸導管造設術を施行した.病理組織学的には, 透明な空胞に圧排された偏在核を持つ印環細胞と低分化な腺癌組織を認めた.PSA染色では細胞質が染色された.術後13ヵ月経過した現在, 再発・転移なく, 外来通院中である

A 76-year-old male was admitted with a complaint of dysuria. Serum prostatic specific antigen was 28 ng/ml. Transperineal prostatic biopsy was performed and histopathological diagnosis was signet ring cell carcinoma with a part of poorly differentiated adenocarcinoma. Imaging studies showed that the tumor was localized in a large part of the prostate, and no abnormality was found in the stomach, the intestine, or the colon. Cystoprostatectomy and ileal conduit construction were performed in November 2002. Immunohistochemistry revealed that the specimen included the signet ring cells, which were stained for prostate specific antigen antibody, but not with periodic acid schiff. He is alive with no evidence of disease in 13 months after the operation.