Metastatic prostate cancer (bone scan)

Case contributed by Bruno Di Muzio


Oncology clinics follow-up.

Patient Data

Age: 75-year-old
Gender: Male

Bone Scan

Nuclear medicine

Whole body bone scan was performed. There are multiple foci of abnormal uptake throughout the skeleton, e.g. right acromion, bilateral scapulae, multiple ribs bilaterally (especially left 9th rib), thoracolumbar spine at multiple levels (especially mid- thoracic spine), bilateral bony pelvis and right femoral neck.

Case Discussion

Widespread osteoblastic bone metastases.

MICROSCOPIC DESCRIPTION: Sections show bony trabeculae and fibrous connective tissue extensively infiltrated by solid sheets, cribriform glands and single tumor cells containing pale cytoplasm, round nuclei and prominent nucleoli. Areas of tumor cell necrosis are present. No lymphovascular or perineural invasion is seen. Immunohistochemical results show tumor cells stain: PSA+, PSAP+, AMACR+, TTF1 focal+, CK7-, CK20-, CDX2- and Tyrosinase-. The features are those of metastatic prostatic acinar adenocarcinoma, Gleason score 5+4=9. No small cell component is seen.

DIAGNOSIS: Thoracic spine: Metastatic prostatic acinar adenocarcinoma; Gleason score 5+4=9.

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