Small cell-like glandular proliferation of prostate: A rare lesion not related to small cell prostate cancer

Virchows Arch. 2017 Jan;470(1):47-54

Kryvenko ON, Williamson SR, Trpkov K, Gupta NS, Athanazio D, Selig MK, Smith PT, Magi-Galluzzi C, Jorda M


Small cell-like change (SCLC) is a rare prostate lesion which has been described in only two previous studies (total of eight cases). Its relation to possible neuroendocrine differentiation remained unclear. We evaluated 11 SCLC cases with immunohistochemistry and electron microscopy. SCLC was characterized by crowded hyperchromatic small nuclei with scant cytoplasm, rosette-like structures, finely granular chromatin with indistinct nucleoli, and lack of mitoses, apoptoses, and necroses. In nine cases, SCLC was admixed with high-grade cancer, and in two cases, it represented a separate intraductal process, spatially remote from a low-volume Gleason score 6 (grade group 1) cancer. Only 2/11 SCLC labeled for synaptophysin, chromogranin, and serotonin, although 6/11 were at least focally positive for TTF1. Staining for NKX3.1 and pancytokeratin was typically weak, focal, and markedly reduced compared to the adjacent cancer. SCLC was positive for ERG in 1/8 and for racemase in 6/10 cases, again typically in a focal and weak fashion. There was no immunoreactivity with CD56, p63, or HMWCK. Ki-67 highlighted only rare nuclei (<1 %). No neuroendocrine granules were demonstrated by electron microscopy in four cases that showed no immunoreactivity for neuroendocrine markers. In summary, SCLC is more frequently found in high-grade prostate cancer, but it may also be encountered as a noninvasive lesion in Gleason score 6 (grade group 1) cancer. Importantly, it does not appear to indicate neuroendocrine differentiation. The low-grade cytology, the lack of mitoses and apoptoses, and the minimal Ki-67 reactivity are findings to support its discrimination from a small cell carcinoma.


It’s Movember, time to Grow a Mo for a Bro!

It’s Movember, time to grow your moustache to raise funds and awareness of some serious health risks that men face, like suicide, testicular cancer and prostate cancer. Maybe growing a moustache isn’t your thing? No problem, host a Mo-ment for the men in your life instead!

APCaRI is a key stakeholder in the TrueNTH Global Registry; contributing 92% of the submitted patients in February 2018. Recently described by Evans et al., 2017 in an article published in BMJ Open, this project was established as an international registry with the goal to monitor the care of men with localised prostate cancer from 13 Movember-fundraising countries. Prostate cancer treatment and outcomes for men vary according to where they live, their race and the care they receive. The TrueNTH Global Registry is collecting a dataset based on the International Consortium for Health Outcome Measures (ICHOM) so we can better understand how to improve the care and treatment of men with localized prostate cancer, regardless of ethnicity and geography.

Please check out previous APCaRI blog posts that have talked about Movember (@Movember); the international Mens’ health Awareness charity, and about TrueNTH (@TrueNTH_Canada); a program funded by Prostate Cancer Canada (PCC) and the Movember Foundation that aims to improve the quality of life of men with prostate cancer and their families.

So start growing (or attach) your moustache today to raise funds and awareness to improve mens’ health!

- Perrin Beatty