Quiz WHAT IS YOUR DIAGNOSIS?

The case presents a 63-year-old male who underwent a radical prostatectomy. The pathology result revealed a bilateral acinar prostatic adenocarcinoma Gleason score 7 (4 + 3) (60 : 40%), Grade Group 3 (WHO), without extraprostatic extension; pT2 N0. Presence in one of the sections from the peripheral zone of the prostate (right lateral) of a 1 mm periglandular stromal focus with the morphology of intraprostatic adipose tissue (Fig. 1), without tumour infiltration in it. Histologically, in this microscopic focus with “brown fat-morphology”, the cells show multivacuolar cytoplasm and a rounded, centrally located nucleus (Fig. 2). The initial immunohistochemical investigation shows an absence of prostatic-specific antigen expression (data not shown); the S100 protein shows intense, simultaneous nuclear and cytoplasmic expression diffusely in the cells with “brown adipocytes morphology” (Fig. 3). Additional immunohistochemical examination, however, contrary to the original diagnostic idea, showed the multivacuolated cells in stromal lobules with strong expression for chromogranin (Fig. 4), synaptophysin, and GATA3 (data not shown).

Answers should be sent to the Editorial Office until 15^th September 2024. The correct answer will be announced in the next issue of the Polish Journal of Pathology.