Journal List > Korean J Cytopathol > v.19(2) > 1006526

Korean J Cytopathol. 2008 Sep;19(2):183-187. English.
Published online September 30, 2008.
Copyright © 2008 The Korean Society for Cytopathology
Fine Needle Aspiration Cytology of Metastatic Prostatic Adenocarcinoma, Pseudohyperplastic Variant
Youngmee Kwon, M.D., Won Seo Park, M.D., Geon Kook Lee, M.D. and Eun Kyung Hong, M.D.
Department of Pathology, National Cancer Center Hospital, Goyang, Gyeonggi, Korea.
Received July 21, 2008; Accepted September 08, 2008.


Pseudohyperplastic prostatic adenocarcinoma is a rare histologic variant of prostatic adenocarcinoma that resembles benign nodular hyperplasia. Immunohistochemistry can verify the absence of basal cells, but it is frequently admixed with conventional adenocarcinoma. Because fine needle aspiration cytology is rarely performed in primary prostatic adenocarcinoma, the cytology of the pseudohyperplastic variant has not been described. We experienced a case of metastatic pseudohyperplastic adenocarcinoma in a pulmonary nodule of 75-year-old man. The cytologic smear was mostly composed of large, flat sheets with elongated branching papillae in a clean background. The sheets showed a well-defined honeycomb appearance of tall columnar, regularly arranged monotonous cells with little cytologic atypia. In subsequent prostatic biopsy, pseudohyperplastic variants were identified together with conventional adenocarcinoma of Gleason's grade 3 and 4. The cytologic features of pulmonary nodules were identical to those of pseudohyperplastic components of prostatic adenocarcinoma.

Keywords: Fine needle aspiration cytology; Pseudohyperplastic variant; Prostate; Adenocarcinoma; Metastasis


Fig. 1
Cytologic findings of pulmonary nodule. Variable sized monolayered sheets in clean background. No isolated cells are noted. The periphery of sheets shows en profile view of tall columnar cells, having basally located nuclei and abundant pale eosinophilic cytoplasm. (Inset) Close-up view of these sheets shows monotonous small round and centrally located nuclei and distinct but not prominent nucleoli. Cytoplasmic borders are well defined, hexagonal, showing honeycomb appearance. (Papanicolaou stain).
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Fig. 2
Cytologic findings of pulmonary nodule. These broad irregular shaped sheets show some luminal structures, indicating complicated glandular structures (Papanicolaou stain).
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Fig. 3
Histopathologic findings of prostate needle biopsy. In pseudohyperplastic adenocarcinomatous component, filiform or complicated branching papillae of tall columnar cells are noted. These papillary structures are complicated by frequent fusion and bridging. (Inset) High power view of the tumor cells shows monotonous small round nuclei, identical to those of pulmonary nodule.(H&E).
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Fig. 4
(A) Histopathologic findings of prostate needle biopsy. The neoplastic glands of pseudohyperplastic adenocarcinoma are large and closely packed or compact with elongated papillae. (B) Immunohistochemical staining for 34E12. Pseudohyperplastic component shows complete loss of basal cells. (Immunohistochemical stain).
Click for larger image

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