GUT: Prostate Pathology Flashcards
Another name for benign prostatic hyperplasia?
BNH Benign nodular hyperplasia
Histology: Lots of polymorphs extending into prostatic glands
Prostatitis (benign)
Which tissues increase in amount in BPH?
Glandular and stromal tissues which form a nodule
Where do BPH nodules usually form?
Transitional or central zone
What causes BPH?
Androgen/oestrogen imbalance leading to increased glands and stromal tissue
SUrgical management of BPH?
TURP (trans urethral resection of prostate)
Most common tumour in males?
Prostate carcinoma
Which serum marker rises in BPH and prostate carcinoma?
PSA
Investigations for prostate carcinoma?
DRE
Biopsy with TRUS needle (7 cores)
Trans rectal ultrasound (TRUS)
MRI/CT
Bone scan (causes sclerosis, rather than necrosis or lysis in the bone)
Most common type of prostate carcinoma?
Acinar (90%)
Ductal 5%
Rare types 5%
How is a TRUS biopsy performed?
Under USS guidance, 7 cores taken from left and right sides of the prostate gland
Treatment of prostate carcinoma?
Hormonal therapy
Radiotherapy
Rarely, radical prostatectomy
Brachytherapy (not in NI, radio isotope seed implants)
What scoring system is used for prostate cancer?
Gleason score out of 10 (eg 3+4, 2+4
Because often more than one pattern is present and the two most common patterns are scored from 1 to 5
1=more differentiated pattern
5=less differentiated pattern
Indication for radical prostatectomy?
Only performed if PSA<15
Gleason score <7 on biopsy
It is a MAJOR surgery
pT1 prostate cancer
Small grade tumour
