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Related articles to: NKX3-1 antibody
- Decompensated heart failure (DHF) may occasionally conceal an underlying systemic malignancy. Persistent hematological abnormalities, particularly thrombocytopenia and markedly elevated alkaline phosphatase (ALP), extending beyond the acute phase of illness warrant systematic evaluation for bone marrow pathology or infiltrative disease, irrespective of the presenting diagnosis. A 53-year-old man with no prior comorbidities presented with DHF, bicytopenia (anemia and thrombocytopenia), and markedly elevated ALP. He developed disseminated intravascular coagulation (DIC) during hospitalization, managed with fresh frozen plasma (FFP), platelet concentrates, and cryoprecipitate, with subsequent resolution; however, thrombocytopenia and ALP elevation persisted. Bone marrow examination revealed infiltration by metastatic adenocarcinoma. Despite comprehensive evaluation including gastrointestinal endoscopies, contrast-enhanced computed tomography (CT), and 18-fluorodeoxyglucose positron emission tomography-CT (18-FDG PET-CT), the primary site remained elusive in the setting of multiple elevated tumor markers: prostate-specific antigen (PSA), carcinoembryonic antigen (CEA), and carbohydrate antigen (CA) 19-9. Immunohistochemistry of the bone marrow biopsy demonstrated positivity for cytokeratin (CK) and NKX3.1, establishing prostatic origin. Subsequent prostate biopsy confirmed left-lobe prostatic adenocarcinoma with a Gleason score of 4+3=7 (Grade Group 3), tumor comprising 70% of the biopsy core, and perineural invasion, consistent with high-risk locally advanced disease. The patient was commenced on androgen deprivation therapy (ADT). Persistent thrombocytopenia and markedly elevated ALP may represent the sole initial manifestation of occult metastatic prostate cancer, even in young patients with no urological symptoms. Immunohistochemistry, particularly NKX3.1, is indispensable in establishing prostatic origin when the primary site remains radiologically occult after comprehensive investigation. - Source: PubMed
Publication date: 2026/07/13
Krishnegowda RaviRao V R SrinidhiMalipatil Ramangouda - Metastatic tumors of the nasal cavity and paranasal sinuses are rare, and the prostate is a particularly uncommon primary site. Including metastatic prostate cancer in the differential diagnosis of sinonasal tumors can be clinically challenging. To our knowledge, there are no detailed case reports confirming uptake in paranasal sinus metastases from prostate cancer using F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). The patient was a 68-year-old man who was diagnosed with prostate cancer 16 years prior to his visit. After a 10-year remission, he received radiation therapy and radium-223 for prostate cancer 6 years earlier, followed by multiple courses of radiation therapy for lymph node and bone metastases over the next 5 years. His chief complaints were a 2-month history of nasal congestion and a postnasal drip. The tumor was located mainly in the right paranasal sinus and showed signs of bone infiltration and tumor necrosis. FDG-PET/CT showed intense uptake in the mass (maximum standardized uptake value = 15.2). The differential diagnosis included primary and metastatic tumors. Biopsy revealed histological features similar to the primary prostate cancer site from 16 years prior, with prostatic acid phosphatase and NKX3.1 positive staining. The patient was diagnosed with metastatic prostate cancer, underwent palliative radiotherapy, and passed away approximately 23 months after the detection of paranasal sinus metastasis. This case highlights the importance of considering metastasis even in atypical lesions in patients with prostate cancer. - Source: PubMed
Publication date: 2026/08/07
Suzuki KoheiOgawa KazuyukiMakise NaohiroKurosaki HiromasaFunatsu HiroyukiKuyama Junpei - Neuroendocrine prostate cancer (NEPC) is an aggressive treatment-associated lineage state emerging with potent androgen receptor (AR) pathway inhibition. Although treatment-emergent NEPC is increasingly recognized, the transcriptional consequences of sustained AR suppression remain incompletely defined. It remains unclear to what extent AR-targeted therapies reshape cellular identity and engage neuroendocrine-associated transcriptional programs without full lineage-defining differentiation. - Source: PubMed
Publication date: 2026/07/24
Watanabe RyutaChosei MamiArai HarunaMiura NoriyoshiKikugawa TadahikoSaika Takashi - Muir-Torre syndrome (MTs) is a rare autosomal dominant disorder characterized by sebaceous neoplasms and internal malignancies, most commonly colorectal and urothelial cancers. Prostate cancer is exceptionally rare in MTs, with only thirteen cases reported to date. - Source: PubMed
Publication date: 2026/06/23
Marchand-Crety CharlesJacquin Nicolas - Introduction Basal cell markers and prostate lineage markers are routinely used as diagnostic adjuncts in prostatic epithelial lesions. High-molecular-weight cytokeratin (HMWCK/34βE12) highlights basal cells, whereas NKX3.1 is a prostate-restricted nuclear transcription factor with established diagnostic value in prostatic adenocarcinoma. The present study evaluated the diagnostic expression pattern of HMWCK and NKX3.1 and assessed whether NKX3.1 expression was associated with adverse clinicopathological parameters. Materials and methods This prospective observational study included 58 evaluable prostatic epithelial neoplasms received over 24 months at a tertiary care institute. HMWCK and NKX3.1 immunohistochemistry were performed on formalin-fixed paraffin-embedded tissue. NKX3.1 was scored as 0 (0% positive tumor cells), 1 (1-50%), and 2 (51-100%). Statistical analysis included chi-square/Fisher's exact tests, Mann-Whitney U test, Spearman correlation, and logistic regression. Serum prostate-specific antigen (PSA) values were available for analysis in 42 adenocarcinoma cases. Results The final cohort included 57 prostatic adenocarcinomas and one high-grade prostatic intraepithelial neoplasia. Among carcinoma cases, the mean age was 68.09 ± 8.04 years. HMWCK was absent in all adenocarcinoma cases, while NKX3.1 was positive in 55/57 cases (96.5%). NKX3.1 scores were 0 in two cases (3.5%), 1 in 30 cases (52.6%), and 2 in 25 cases (43.9%). Worst Gleason Grade Group showed a weak but significant inverse correlation with NKX3.1 score (Spearman rho = -0.286, p = 0.031). Perineural invasion (PNI) showed the strongest association with NKX3.1 expression; reduced NKX3.1 expression was present in 20/22 PNI-positive tumors compared with 12/35 PNI-negative tumors (p < 0.001; OR 19.17). Serum PSA also correlated inversely with NKX3.1 score among cases with available values (rho = -0.367, p = 0.017), and core involvement percentage correlated inversely with NKX3.1 score (rho = -0.365, p = 0.006). Conclusions HMWCK and NKX3.1 showed complementary diagnostic utility in prostatic adenocarcinoma. HMWCK supported invasive adenocarcinoma by demonstrating basal cell loss, while NKX3.1 was retained in most carcinomas as a sensitive prostatic lineage marker. Reduced NKX3.1 expression was associated with higher worst Grade Group, PNI, serum PSA, tumor core involvement, and adverse clinical status. The strongest association was observed between PNI and reduced NKX3.1 expression. - Source: PubMed
Publication date: 2026/06/19
Singh AyushiImam Zeenat SKumari MamtaKumar BipinRanjan Nikhil