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Double cocktail immunostains with high molecular weight cytokeratin and GATA-3: useful stain to discriminate in situ involvement of prostatic ducts or acini from stromal invasion by urothelial carcinoma in the prostate

Journal of Pathology and Translational Medicine 2020년 54권 2호 p.146 ~ 153
이정혜, Yoo Young-Eun, 박상희, 조민선, 성순희, 노재윤,
소속 상세정보
이정혜 ( Lee Jung-Hye ) - Ewha Womans University College of Medicine Department of Pathology
 ( Yoo Young-Eun ) - Ewha Womans University College of Medicine Department of Pathology
박상희 ( Park Sang-Hui ) - Ewha Womans University College of Medicine Department of Pathology
조민선 ( Cho Min-Sun ) - Ewha Womans University College of Medicine Department of Pathology
성순희 ( Sung Sun-Hee ) - Ewha Womans University College of Medicine Department of Pathology
노재윤 ( Ro Jae-Y. ) - Cornell University Weill Medical College Houston Methodist Hospital Department of Pathology and Genomic Medicine

Abstract


Background: Distinguishing prostatic stromal invasion (PSI) by urothelial carcinoma (UC) from in situ UC involving prostatic ducts or acini with no stromal invasion (in situ involvement) may be challenging on hematoxylin and eosin stained sections. However, the distinction between them is important because cases with PSI show worse prognosis. This study was performed to assess the utility of double cocktail immunostains with high molecular weight cytokeratin (HMWCK) and GATA-3 to discriminate PSI by UC from in situ UC involvement of prostatic ducts or acini in the prostate.

Methods: Among 117 radical cystoprostatectomy specimens for bladder UCs, 25 cases showed secondary involvement of bladder UC in prostatic ducts/acini only or associated stromal invasion and of these 25 cases, seven cases revealed equivocal PSI. In these seven cases with equivocal PSI, HMWCK, and GATA-3 double immunohistochemical stains were performed to identify whether this cocktail stain is useful to identify the stromal invasion.

Results: In all cases, basal cells of prostate glands showed strong cytoplasmic staining for HMWCK and UC cells showed strong nuclear staining for GATA-3. In cases with stromal invasion of UC, GATA-3-positive tumor cells in the prostatic stroma without surrounding HMWCK-positive basal cells were highlighted and easily recognized. Among seven equivocal cases, two cases showed PSI and five in situ UC in the prostate. In two cases, the original diagnoses were revised.

Conclusions: Our study suggested that HMWCK and GATA-3 double stains could be utilized as an adjunct method in the distinction between PSI by UC from in situ UC involving prostatic ducts or acini.

키워드

Urothelial carcinoma; Prostatic stromal invasion; High molecular weight cytokeratin; GATA-3

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