Immunocytochemical study of urine cytological preparations from secondary prostatic adenocarcinoma involving the...

Involvement of the urinary bladder by prostatic adenocarcinoma (PCA) occasionally occurs. In this study, we analyzed urine cytological findings in patients with secondary involvement of the urinary bladder by PCA with the help of the immunocytochemistry. The cases were divided into two groups: (1) prospective study group: three cases; and (2) retrospective study group: 12 cases which were retrieved from our cytopathological files. The urine cytology specimens (cytospins) from all cases were submitted for prostatic specific antigen (PSA) immunocytochemistry. Additional immunostaining for high-molecular-weight cytokeratin (HMWCK) was performed if PSA immunoreactivity was negative. All cytospin smears showed atypical cells characterized by large, round and uniform nuclei with prominent nucleoli and dense cytoplasm. They were present as single cells or in cell groups simulating urothelial carcinoma. The diagnosis of PCA was made if the atypical cells were either immunoreactive for PSA or nonreactive for HMWCK. The urothelial cells were PSA- and HMWCK+. The immunostaining supported the PCA diagnosis in all three cases from the prospective group and two cases in the retrospective group. The remaining 10 cases in the retrospective group were diagnosed as negative: 3, atypia: 5 urothelial carcinoma: 2. The positive diagnosis for PCA was based on the PSA immunoreactivity or nonreactivity to HMWCK and the cytological atypia. In conclusions, immunostaining for PSA and HMWCK performed on cytospins of urine specimens from patients with a prior history of high-grade and/or stage of PCA is helpful to make a positive diagnosis of secondary bladder involvement from PCA.