B8-042 Prostate Pathology Flashcards
prostate cancer arises from the […] zone
peripheral
BPH arises from the […] zome
transition
what zone of the prostate surrounds the prostatic urethra?
transition
what zone of the prostate surrounds the ejaculatory duct?
central
what zone of the prostate is palpable on digital rectal exam?
peripheral
what zone of the prostate is composed of non-glandular tissue and fibromuscular stroma?
anterior
tenderness on DRE may indicate
prostatitis
enlargement on DRE may indicate
BPH
hard nodule on DRE may indicate
prostatic cancer
2 types of BPH
epithelial predominant
stromal predominant
type of BPH that is nodules composed of tightly clustered expanded ductal acinar elements
epithelial predominant
type of BPH that is bland spindle cells with small cytoplasm and large nuclei
stromal predominant
the secretory cells of the prostate secrete
PSA
only secretory epithelium
loss of basal cells
prostatic adenocarcinoma
how does excess estrogen cause BPH?
disrupts balance between epithelial cell proliferation and cell death
more proliferation
how does excess DHT cause BPH?
stimulates growth factor receptors on both stromal and epithelial cells –> hyperplasia
if the specimen does not take up HMW-CK stain, what is likely?
prostatic adenocarcinoma (no basal layer)
HMW-CK stains basal layer
prostatic adenocarcinoma is graded using the […] grade
Gleason grade
(based on glandular architecture and correlates with metastatic potential)
metastasis of prostatic adenocarcinoma to the spine occurs via
vertebral (Batson) venous plexus
increased total PSA
increased fraction of free PSA
BPH
increased total PSA
decreased fraction of free PSA
prostatic adenocarcinoma
hot, boggy, tender prostate
acute bacterial prostatitis
fever, chills, malaise with
irritative and obstructive symptoms
acute bacterial prostatitis
what do you need to see on histology to diagnose acute bacterial prostatitis?
neutrophils
[…] treatment is a common cause of granulomatous chronic bacterial prostatitis
BCG
what do you need to see on histology to diagnose chronic bacterial prostatitis?
lymphocytes
granulomas on histology and chronic bacterial prostatitis in a patient with hx of bladder cancer
post-BCG granulomatous inflammation
prostate cancer causes […] lesions of the bone
osteoblastic
standard of care for diagnosis of prostatic adenocarcinoma
MRI
patients under […] years of age do not need prostate screening
40
patients over […] years of age do not need prostate screening
70
rising PSA in a perviously treated patient signifies
biochemical recurrence
treatment recommendation for Gleason grade 3+3 = Score 6
yearly biopsies (active surveillance)
treatment recommendation for Gleason grade 3+4 = Score 7 and above
radical prostatectomy
alpha blockers inhibit smooth muscle tone by inhibiting […] receptors
a1 adrenergic
genetic changes associated with prostatic adenocarcinoma [5]
Loss of p53
PTEN Deletion
MYC Amplification
BRCA2
ERG-TMPRSS2 fusion
most common pathogen causing acute bacterial prostatitis
E coli
