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.