Prostatic adenocarcinoma with focal pleomorphic giant cell features is rare with the only prior series consisting of 6 cases. From 2005 to 2018, we identified 29 cases from our consult service and 1 case from our own institution. Men ranged in age from 39 to 90 years (median=75.5). Diagnostic specimens consisted of needle biopsies (n=13); transurethral resections (n=7), urethral/bladder biopsies (n=8), radical prostatectomy (n=1), and orchiectomy (n=1). In all cases, there was usual acinar prostatic adenocarcinoma, where the highest grade in all cases was Gleason score 9 to 10 (Grade Group 5). On average, 68% of the involved cores had cancer with a maximum percent of cancer averaging 55%; on average, transurethral resections had 85% of the area involved by cancer. Areas of cancer showing pleomorphic giant cell features were focal (<5%). Two of the needle biopsies showed extraprostatic extension. The radical prostatectomy had seminal vesicle invasion and positive margins with lymphovascular invasion. Prostatic adenocarcinoma with focal pleomorphic giant cell features is always accompanied by extensive usual acinar prostate adenocarcinoma where the highest grade in all cases was Gleason score 9 to 10 (Grade Group 5). Although the pleomorphic component is focal, it can mimic urothelial carcinoma. IHC can be misleading as PSA staining is often negative or focal in both the pleomorphic and usual prostatic adenocarcinoma components. NKX3.1 is the most sensitive prostate marker, but was still focal in 1 usual prostatic adenocarcinoma and negative in 2 pleomorphic components. Prostatic adenocarcinoma with focal pleomorphic giant cell features has a dismal prognosis. In men with no prior diagnosis of prostate adenocarcinoma and >1-year follow-up, 7/19 (37%) were dead at a median of 8 months after diagnosis. Of the 7 men with a prior history of prostate adenocarcinoma, 4/7 (57%) were dead at a median of 7 months after diagnosis of recurrent prostate adenocarcinoma with pleomorphic giant cell features.

Abdullah M. Alharbi

Angelo M. De Marzo

Jessica L. Hicks

Tamara L. Lotan

Jonathan I. Epstein

American Journal of Surgical Pathology

《美国外科病理学杂志》因其对人类外科病理学最新进展的出色报道而获得了全世界的认可。在每个月刊中，专家都会展示原创文章、评论文章、详细的病例报告和专题，并辅以精美的插图。覆盖范围包括技术方法、诊断辅助和冰冻切片诊断，以及对广泛疾病实体的详细病理学研究。 ARTHUR PURDY STOUT 外科病理学家协会和胃肠病理学协会的官方杂志。

The American Journal of Surgical Pathology is globally recognized for its outstanding reporting on the latest advancements in human surgical pathology. Each monthly issue features original research articles, review articles, detailed case reports, and special topics, complemented by high-quality illustrations. The scope includes technical methods, diagnostic aids, frozen section diagnosis, and in-depth pathological studies of a wide range of disease entities. It is the official journal of the ARTHUR PURDY STOUT Society of Surgical Pathologists and the Society for Gastrointestinal Pathology.

《美国外科病理学杂志》因其对人类外科病理学最新进展的卓越报道而获得全球认可。每期杂志中，专家们展示原创研究文章、评论、详细病例报告和专题，辅以精美插图。内容涵盖技术方法、诊断辅助、冰冻切片诊断，以及对多种疾病的详细病理学研究。该杂志是ARTHUR PURDY STOUT外科病理学家协会和胃肠病理学协会的官方出版物。

Category	Quartile
医学	1
医学, 病理学	1
医学, 外科	1

Prostatic Adenocarcinoma With Focal Pleomorphic Giant Cell Features

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