PMC5107239_01
Prostate MRI with coronal (a) and axial (b) views showing marked enlargement of prostate gland with architecture derangement. Urethra with Foley (arrow) was shifted to the right side.
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fig1
Architecture derangement of prostate, possible central necrosis with hemorrhage, and enlarged right internal iliac lymphadenopathy were found on prostate magnetic resonance imaging (MRI) (Figure 1).
Microscopic findings of the transurethral resection biopsy specimen. (a) Low-power view shows spindle cells arranged in tightly packed fascicles, with alternating hypo- and hypercellular areas and geographic necrosis (H&E stain, x40). (b) High-power view shows spindle-shaped tumor cells with hyperchromatic nuclei and frequent mitoses. Some entrapped prostatic glands are also seen (H&E stain, x400). (c) By immunohistochemistry, the tumor cells demonstrate focal immunopositivity of S-100 protein (Immunoperoxidase, x200) and (d) no immunoreactivity with CDK4 (Immunoperoxidase, x200).
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fig2
TRUS-guided prostate biopsy but massive gross hematuria attacked days after the procedure. Thus, cystoscopy for checking bleeding was done and the specimen resected from prostate was reported as malignant peripheral nerve sheath tumor (Figure 2).