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Inflammation-associated pathologies in a case of prostate schistosomiasis: Implications for a causal role in prostate carcinogenesis
- Source :
- The Prostate. 79(11)
- Publication Year :
- 2019
-
Abstract
- Background Urogenital infection with Schistosoma haematobium is a risk factor for the development of squamous cell carcinoma of the urinary bladder. The pathophysiology is thought to be mediated in part by inflammation, cellular damage, and bladder regeneration induced by the parasitic infection. Herein, we report an unusual case of schistosomiasis of the prostate that was found concurrent with prostate adenocarcinoma in a radical prostatectomy specimen from a man in the United States. Methods The infecting Schistosoma species was characterized via histomorphology and acid-fast stain. The concurrent Gleason score 6 prostate cancer was assessed for ETS transcription factor ERG (ERG), phosphatase and tensin homolog (PTEN), p27, and p53 status using immunohistochemistry (IHC). Cellular proliferation and the presence of intermediate cells in prostatic atrophy were assessed via immunostaining for Ki67 and CK903, respectively. Results Histomorphology and acid-fast stain of the infecting species were consistent with S. haematobium. We classified the Gleason score 6 prostate adenocarcinoma via IHC as ERG positive, PTEN intact, p27 intact, and without p53 nuclear accumulation. The prostatic epithelium immediately adjacent to the schistosomiasis-related granulomatous inflammation was atrophic and accompanied by increased cellular proliferation and the presence of intermediate cells. Upon literature review, we determined that prostate schistosomiasis is associated with a young age of prostate cancer diagnosis and highly aggressive prostate cancer. Conclusions This is a rare case of prostate schistosomiasis in the United States; however, prostate schistosomiasis occurs frequently in endemic areas. The patient had traveled to a Schistosoma-endemic region, which was the likely location of exposure to the parasite. To our knowledge, this is the first report of the association of proliferative inflammatory atrophy and intermediate cells with schistosomiasis of the prostate. We propose that prostate schistosomiasis may be considered as a risk factor for the development of prostate cancer in geographic regions where Schistosoma species are endemic.
- Subjects :
- 0301 basic medicine
Male
Pathology
medicine.medical_specialty
Carcinogenesis
Urology
medicine.medical_treatment
Schistosomiasis
Adenocarcinoma
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Prostate
Medicine
PTEN
Humans
Schistosoma haematobium
Inflammation
Prostatectomy
Urinary bladder
biology
business.industry
ETS transcription factor family
Prostatic Neoplasms
Middle Aged
medicine.disease
biology.organism_classification
030104 developmental biology
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
biology.protein
business
Subjects
Details
- ISSN :
- 10970045
- Volume :
- 79
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- The Prostate
- Accession number :
- edsair.doi.dedup.....f59d32c55035a231e0adff6e5bd51127