Histopathology - Prostate

Question 1

Answer 1

Prostate Hyperplasia

 Bluish areas = nuclei from lymphocyte crowding, indicating chronic inflammation

 Glandular tissue with basal layer and apical cuboidal layer

 Fibromuscular stroma

o Smooth muscle cells are large and eosinophilic

 In glandular hyperplasia, glandular tissue increases more than the stroma, giving the prostate

an abnormally large glandular tissue:stroma ratio. Glands appear dilated and crowded, with

small septa separating adjacent glands.

 Columnar glandular epithelium of newly formed nodules are generally taller than usual, and

epithelium of older nodules is lower than usual.

o Older nodules undergo pressure atrophy from pressure in the lumen of the glands.

 Cells protrude into lumen (flower-like appearance) due to hyperplasia

 Atrophic and hyperplastic nodes

o Atrophic part in bottom left

 Causes hypertrophy of urinary bladder

 Internal part of prostate surrounds urethra, and does not generally give rise to cancer. (Cancer

usually originates from outer part of prostate)

 Prostate is testosterone-dependent organ, and when testosterone levels decrease with age, the

prostate enlarges to extract more testosterone from the blood.

Question 2

Answer 2

Adenocarcinoma

 Normally we see smooth muscle and glands
 Blank ink at top shows the resection margin

 Lymphocytic proliferation

 Basal layer: inner columnar, outer flattened

 Normal gland structure with some nodular hyperplasia

 Tiny holes: just the inner layer is present

 Nucleoli seen in the single-layered cells forming gland-like structures

 Prostate cancer usually develops at outer margin
 Corpus amylacea may rupture gland  inflammation
 PIN (prostate intraepithelial neoplasm) seen with multilayered glands  Seminal vesicle, lipofuscin