Lung metastasis: from prostate acinar adenocarcinoma

Case contributed by Dr Mikkaela McCormack

Presentation

Whilst undergoing imaging for another reason, a lesion was found in the right lower lung lobe of this 73 year-old man. Video-assisted thoracoscopic surgery (VATS) was performed, and an excisional lung wedge biopsy performed, revealing a solitary tan sub-pleural mass ~2cm in size. Two years previously he had undergone radical prostatectomy for prostate adenocarcinoma.

Patient Data

Age: 73
Gender: Male

H&E Images

Modality: Pathology

Alveolated lung parenchyma shows a solitary deposit of metastatic prostate acinar adenocarcinoma, composed of cribriform and fused glands lined by mildly pleomorphic cuboidal/low columnar epithelium with prominent nucleoli and moderately abundant eosinophilic / pale cytoplasm.  Scattered mitotic figures are present.   The surrounding lung is unremarkable.

Ancillary Studies

Modality: Pathology

Special staining for elastin to assess pleural involvement.

Confirmatory immunohistochemistry to determine primary site of origin. 

Case Discussion

Although having a documented history of Gleason score 7 prostate adenocarcinoma, and tumour morphology consisent with metastatic prostate adenocarcinoma, confirmatory immunohistochemistry studies are still required to be performed to determine the primary site of origin of the tumour deposit.  Other stains performed included cytokeratins 7 and 20 and TTF-1.  

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Case Information

rID: 43992
Case created: 1st Apr 2016
Last edited: 5th Apr 2016
System: Chest
Inclusion in quiz mode: Included

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