Neoplasms of the Prostate

Question 1

Prostate cancer is the __ most common cause of cancer death in men

Answer 1

2nd

Question 2

neoplasms are…

Answer 2

an abnormal growth/mass of tissue that grows faster than normal

Question 3

neoplasms can be classified as

Answer 3

benign or malignant

Question 4

benign neoplasm in the prostate is

Answer 4

benign prostatic hyperplasia

Question 5

benign prostatic hyperplasia

Answer 5

enlargement of the prostate, seen as a nodule, due to increased cell turnover which is normal for men >40/50

Question 6

a malignant neoplasm in the prostate is

Answer 6

adenocarcinoma

Question 7

How do we determine if something is benign or malignant

Answer 7

use the prostate-specific antigen (PSA) and do a digital rectal exam and palpate the prostate for signs of enlargement or irregularities

Question 8

what is prostate-specific antigen (PSA)

Answer 8

a glycoprotein that is produced by prostate epithelial cells that increases with hypertrophy

Question 9

serum levels are normally ____ in adenocarcinoma

Answer 9

higher (>6ng/mL)

Question 10

serum levels are normally ____ in BPH

Answer 10

higher (>4ng/mL)

Question 11

ductal carcinoma may exhibit what kind of PSA

Answer 11

normal

Question 12

Nodules appear where in BPH

Answer 12

transition zone (TZ)

Question 13

nodules may do what in BPH

Answer 13

compress the urethra causing obstructive symptoms that can be seen as chronic bladder obstruction

Question 14

signs of chronic bladder obstruction are

Answer 14

urine retention
renal insufficiency
recurrent UTI
gross hematuria
bladder calculi

Question 15

what lobes are enlarged in BPH

Answer 15

medial and lateral lobes

Question 16

what histological pattern is found in BPH

Answer 16

trabecular

Question 17

is bladder calculus present in BPH

Answer 17

yes

Question 18

Nodules can evolve in what 2 places

Answer 18

glands and stoma

Question 19

what causes enlargement

Answer 19

activation of androgen receptors by DHT

the number of androgen receptors are increased by estrogen

causes on imbalance in cell creation and death

Question 20

DHT inhbits what cell process

Answer 20

apoptosis

Question 21

adenocarcinoma stems from what cells

Answer 21

luminal cells

Question 22

luminal cells do what

Answer 22

line the lumen and produce PSA or Pb and express CK8 and androgen receptors

Question 23

what are the clinical findings of adenocarcinoma of the prostate

Answer 23

nonspecific symptoms such as back pain, urine retention, urine hesitancy, and a weak stream

abnormal rectal exam

Question 24

adenocarcinoma of the prostate can be what 2 types

Answer 24

acinar or ductal

Question 25

adenocarcinoma of the prostate is that most common ______ cancer

Answer 25

non-cutaneous (not arising within the skin)

Question 26

what increases the risk of adenocarcinoma of the prostate

Answer 26

obesity cigarette smoking consumption of animal fats

Question 27

adenocarcinoma of the prostate has what speed of growth

Answer 27

slow

Question 28

is adenocarcinoma of the prostate is metastatic?

Answer 28

yes, to the bones, lungs, lymph, and brain

Question 29

what is a normal PSA level

Answer 29

<4 ng/mL

Question 30

DHT activates what

Answer 30

the androgen receptor

Question 31

BPH is hormonally dependent on the production of what

Answer 31

testosterone and dihydrotestosterone

Question 32

the parthenogenesis of BPH is mainly

Answer 32

activation of the androgen receptor

Question 33

What converts testosterone to DHT

Answer 33

stromal type II 5-alpha reductase

Question 34

What two layers of glandular cells are included in BPH

Answer 34

luminal and basal

Question 35

an intact basal layer is highlighted by

Answer 35

p63 high molecular keratin

Question 36

is there a correlation between histology and symptoms?

Answer 36

no

Question 37

what markers do we look for in BPH?

Answer 37

negative for racemase

Question 38

what is the surgical/tx options for BPH

Answer 38

Transurethral resection of prostate (TURP) Suprapubic prostatectomy androgen antagonist

Question 39

Prostatic adenocarcinoma is predominantly what type?

Answer 39

acinar, less ductal

Question 40

what are the risk factors for prostatic adenocarcinoma

Answer 40

Ashkenazi Jewish ancestry BRCA1, BRCA2, Lynch syndrome CHEK, ATM, HOXB13, etc

Question 41

what are the protective factors for prostatic adenocarcinoma

Answer 41

Lycopenes Coffee Soy products Vitamin D, etc

Question 42

in prostatic adenocarcinoma, what hormones/signaling is over expressed

Answer 42

androgens and androgen receptors

Question 43

how do you screen for prostatic adenocarcinoma

Answer 43

PSA Digital rectal exam Biopsy if abnormal PSA

Question 44

What part of the prostate is prostatic adenocarcinoma more common to occur

Answer 44

posterior

Question 45

What cell zone is prostatic adenocarcinoma more common to occur

Answer 45

peripheral zone (posterior and lateral)

Question 46

How does that prostate feel/symptoms involved with prostatic adenocarcinoma

Answer 46

firm and usually asymptomatic

Question 47

in prostatic adenocarcinoma, is the basal layer involved

Answer 47

no

Question 48

how is prostatic adenocarcinoma graded

Answer 48

based on the gleason score

Question 49

gleason score ranges from

Answer 49

1-5

Question 50

what are markers for prostatic adenocarcinoma

Answer 50

positive racemase and PSA

Question 51

prostatic adenocarcinoma should be negative for what markers

Answer 51

p63 and 34betaE12