Prognostic significance of neuroendocrine differentiation in carcinoma of the prostate.

Biopsies taken by core-needle biopsy and/or transurethral resection to 68 patients with prostatic neoplasia stage III and IV, were studied morphohistochemically. Morphological observations showed high incidence of mixed histopathological forms. The Churukian-Schenk and Garvey silver impregnations were used in order to identify associated neuroendocrine differentiations. Three cases presented monomorphic small cell proliferation which contained numerous argyrophilic cytoplasmic granulations. The prognosis in these cases was poor--the patients died because of neoplastic extension within 5 to 9 months following diagnosis. Neuroendocrine cells were identified in 15 cases, 6 of which presented a malignant pattern. Taking into consideration the hormonal resistance of malignant cells with argyrophilic granulations, the necessity of chemotherapy associated to hormonotherapy is discussed.