1.4.3 Prostate Pathology Flashcards
What type of prostatitis?
Chronic
What this be?
Prostatic adenocarcinoma
Right? Left?
Right: BPH
Left: Normal
What yo got, doc?
Prostatic adenocarcinoma
What is the current cutoff level for PSA levels? What % of adenocarcinoma is below this level?
4 ng/mL; 20-40%
What are the blue and black arrows pointing at?
Blue: benign
Black: malignant
Identify the two cell types?
Top: Secretory
Bottom: Basal
What symptoms are present in localized prostate cancer?
Asymptomatic
What is the most common type of cancer in men?
Prostate
What is the incidence in different age groups?
20% in 50s. 70-80% in 70s and 80s
What are the histological features of prostatic adenocarcinoma?
What other mutations are acquired somatically?
ERG and TMPRSS2 gene fusion
MYC amplification
PTEN deletion
Lost of TP53
What age range of men are at risk for BPH?
> 50 y/o
What type of infections give rise to granulomatous inflammation?
fungal or mycobacteria
What can cause an elevation of PSA?
Cancer, prostatitis, BPH, infarct, instrumentation of prostate, ejaculation
What are the black arrows pointing at?
Perineural invasion
What are the treatment methods?
active surveillence (low grade), radical prostatectomy (localized), external beam or intersitial radiation therapy (localized), hormonal manipulations
What are the three types of treatment available for BPH?
alpha1-adrenergic receptor antagonist
5-alpha-reductase inhibitors
Transurethral resection of the prostate (TURP)
What this be?
Metastatic prostatic adenocarcinoma
What is the precursor lesion of prostatic adenocarcinoma?
high-grade prostatic intraepithelial neoplasia (PIN)
What two stains are important for looking at the prostate?
PSA-ag stain (in secretory cells) and HMW-CK (in basal cells)
What is associated with chronic bacterial prostatitis?
Recurrent UTIs
What are the symptoms of acute bacterial prostatitis? What is the common bacteria resposible?
Fever, chills, dysuria
E. Coli
What has shown to substantially reduce mortality in patients with localized prostatic adenocarcinoma?
Radical prostatectomy
What’s the diagnosis, doc?
BPH
Describe the pathogenesis of BPH
Identify the 3 zones?
CZ: central zone
TZ: Transurethral zone
PZ: Peripheral zone (70% of adenocarcinomas)
What are the three ways to detect prostatic adenocarcinoma?
Digital rectal exam (low sensitivity/specificity)
Multiparameter MRI
Serum PSA level
What are the three types of prostate inflammation?
Acute bacterial
Chronic bacterial or abacterial
Granulomatous
What are the two classifications of symptoms that can arise from BPH?
What are the factors of prognosis in prostatic adenocarcinoma?
PSA level, Gleason grade, Pathologic stage
What this be?
BPH
What zones are responsible for BPH?
CZ and TZ
What germline mutation is associated with prostate adenocarcinoma?
BRCA2
What type of prostatitis?
Acute (note presence of neutrophils)
What are the four main complications that arise from BPH?
Urinary retention, bladder hypertrophy and hyperplasia, vesicoureteric reflex, renal dysfunction
What this be?
Post-BCG Granulomatous Inflammation
What is the treatment for granulomatous inflammation?
BCG Treatment effect
