Foamy gland variant of adenocarcinoma of prostate: a rare pathological variant

Description

A 58-year-old man presented with history of irritative lower urinary tract symptoms (daytime frequency and nocturia) for 3 months. Digital rectal examination revealed grade 2 prostatomegaly and consistency was hard. Serum prostate-specific antigen (PSA) was 2.7 ng/mL. Serum creatinine was 1.2 mg/dL. Transrectal ultrasonography (TRUS) revealed a prostate size of 54x47x56 mm with hypoechoic nodular appearance at superior part of the left lobe. Ultrasound scan of the abdomen was normal. Urinary microscopy revealed 1–2 pus cells and 3–4 erythrocytes. TRUS-guided 12-core biopsy was performed. Microscopic examination of all the biopsy cores revealed fused glandular structures with focal cribriform pattern (Gleason pattern 4+4=8), involving >80% of the prostatic cores (figures 1 and 2). Perineural invasion was evident. Individual cells were polygonal with voluminous foamy cytoplasm, low nucleo-cytoplasmic ratio, pyknotic nuclei and inconspicuous nucleoli. Tumour cells were immunoreactive for PSA while p63 and 34βE12 confirmed the absence of basal...

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