Pathology

Question 1

what is PIN

Answer 1

architecturally benign prostatic acini and ducts lined by cystologically atypical cells
basal layer is present although BM may be fragmented
high vs low depending on prominence of nucleoli

Question 2

facts about HG PIN
precursor
location

Answer 2

may be precursor, unproven

location of PIN does not correspond location PCa

Question 2

facts about HG PIN
precursor
location

Answer 2

may be precursor, unproven

location of PIN does not correspond location PCa

Question 3

does HG PIN secrete PSA

Answer 3

no

Question 4

chance of pca on repeat biopsy if 1 core contains PIN

Answer 4

20% up to 70% if more than 1 core

Question 5

EAU recommendation PIN

Answer 5

no recommendation to repeat biopsy

Question 6

what is ASAP
histology features 3
detection rate PCa on repeat biopsy vs HGPIN

Answer 6

atypical small acinar proliferation
acini lined with cystologically abnormal epithelium and may exhibit atrophic features
basal layer focally absent
columnar cells have prominent nucleoli

40%

Question 7

gleason grading

Answer 7

grade 1 = well demarcated nodule
grade 2 = irregular spacing and irregular outline
grade 3= variability in gland shape and spacing
grade 4= gland fusion
grade 5 = diffuse solid sheet of undifferentiated cells

CYTOLOGICAL FEATURES DO NOT PLAY A PART

Question 8

% under representation of gleason score based on RP

Answer 8

common 30-40%

over representation is uncommon 5%

Question 9

what is most important prognositc indicator following radical treatment

Answer 9

gleason score

Question 10

psa encoded on chromosome

Answer 10

19

Question 11

PSA half life

Answer 11

2-3 days

Question 12

PSA half life

Answer 12

2-3 days

Question 13

BPH contribution to PSA

Answer 13

1g BPH contributes 0.15 to 0.3 ng/ml of PSA

Question 14

PSA vs HK2 expression malignant and benign

Answer 14

benign HK2 expression low PSA intense

compared to cancer, more intense HK2 expression

Question 15

what is total PSA

Answer 15

free PSA + bound to ACT

Question 16

osterling ranges

source of data

Answer 16

Olmsted country 471 men
with completed TRUS, PSA and DRE
no prostate cancer found on these
40-49 2.5
50-59 3.5
60-69 4.5
70-79 6.5

95th centile ranges for upper threshold

Question 17

% of PSA above 3 will not have pca

%pSA below 3 will have pca

Answer 17

75%

15%