case_images: PMC7759404_01
case_images: Negative GATA3 and positive NKX3.1 staining confirms prostatic adenocarcinoma. Low power view of the bladder tumor in (a) shows a normal urothelial mucosa and tumor beneath the urothelium, involving the submucosa. Underlying invasion of the muscularis propria was also present. (b) Strong diffuse nuclear staining with the immunohistochemical stain NKX3.1 was seen. Note the surface urothelium is negative. (c) The tumor cells are negative for the immunohistochemical stain GATA3, while the surface benign urothelium shows positive nuclear staining.
case_images: CRIU2020-8855451.001.jpg
case_images: PMC7759404_01_CRIU2020-8855451.001.jpg
case_images: fig1
case_images: TURBT specimen. This revealed diffuse strong nuclear staining of NKX3.1 with GATA3 positivity only seen in benign surface epithelium supporting a diagnosis of prostatic adenocarcinoma (Figure 1).
case_images: PMC7759404_02
case_images: NKX3.1 distinguishes prostatic origin amidst significant cautery artifact. (a) Tumor cells can be seen infiltrating through smooth muscle tissue, which appear epithelioid, but otherwise show no distinguishing features. These tumor cells are in a background of inflammation and appear cauterized, making it difficult to classify based on morphology alone. (b) The immunohistochemical stain NKX3.1 shows strong nuclear positivity in the tumor cells. In contrast (c), the larger tumor cell nuclei are negative for the immunohistochemical stain GATA3 and only show nonspecific faint blushing of the cytoplasm. GATA3 is appropriately positive in an occasional small background of benign lymphocyte nuclei.
case_images: CRIU2020-8855451.002.jpg
case_images: PMC7759404_02_CRIU2020-8855451.002.jpg
case_images: fig2
case_images: Staining for NKX3.1 and GATA3 showed strong nuclear positivity in the tumor cells while GATA3 was appropriately confined to benign lymphocyte nuclei, confirming a diagnosis of prostate adenocarcinoma (Figure 2).
case_images: PMC7759404_03