137. Carcinoma of the prostate.

Question 1

Prostate adenocarcinoma definition, origin, risk factors, location

Answer 1

definition: malignant proliferation of prostatic glands
origin: luminal or basal cells

most common cancer in men

risk factors: old age, high fat/low fiber diet, family with prostate cancer, african american

arises at the peripheral zone of the prostate

Question 2

pathogenesis

Answer 2

androgens have a major role, hereditary, environmental factors, and acquired somatic mutations like TMPRSS2 gene fusion with ETS family transcription factors or oncogenic PI3K/AKT signaling

Question 3

features

Answer 3

slow growth, invasive mostly to bones (vertebra), lungs, lymph nodes, lymphatic and hematogenous spread

Question 4

morphology

Answer 4

moderately differentiated adenocarcinomas that produce well-defined glands that are usually closely packed without basal cell layer

Question 5

pre-cancerous lesion

Answer 5

high grade prostatic intraepithelial neoplasia –> latent prostatic carcinoma –> advanced prostatic carcinoma

Question 6

symptoms

Answer 6

dysuria, blood in urine, ejaculation issues, discomfort in pelvic area

Question 7

diagnosis

Answer 7

elevated PSA

biopsy for gleason grading system: 2 most common cell types are graded from 1 to 5, giving a total score of 2-10