A 58-year-old man presents to the emergency depament with severe back pain. His history is negative for trauma and he has no other complaints. He denies urinary frequency, hesitancy, or dysuria. A digital rectal examination confirms the presence of a firm, hard, asymmetrical and stony prostate, suggestive of prostatic malignancy. In addition to PSA, which of the following markers can be demonstrated in the tumour cells?
AMACR
AFP
Podoplanin
OCT-3/4
On immunohistochemistry, in addition to PSA, another useful marker is a-methylacyl coenzyme A racemase (AMACR), which is upregulated in prostate cancer. Most prostate cancers are positive for AMACR, the sensitivity varying among studies from 82% to 100%. Seminomas are positive for KIT, OCT-3/4, podoplanin. Embryonal carcinomas are also positive for OCT-3/4. The expression of AFP (alpha fetoprotein) is characteristic of yolk sac tumor cells; stains for cytokeratin are also positive.
Systemic Pathology