Pathophysiology of PCa

Question 1

What is shape of prostate gland and cases?

Answer 1

• solid, round walnut shaped
• btwn neck bladder + urogenital diaphragm
  > adenocarcinomas than small cell neuroendocrine cancers, sarcomas + transitional cell carcinomas

Question 2

How is PCa graded?

Answer 2

1. histological appearance of malignant cells
   - well
   - moderately
   - poorly differentiated

Question 3

How does Gleason score work?

Answer 3

1 - well differentiated (better prognosis)
5 - poorly differentiated (poor prognosis)
scores 2 specimens combined

Question 4

How does metastatic spread occur?

Answer 4

• local extension
• lymphatic drainage
• haemotgenous dissemination
• lymphangitic / nodular pulmonary infiltrates on autopsy

Question 5

Two common types of metastases in PCa

Answer 5

1. Pelvic + abdominal lymph node
2. Lumbar spine - common site for haemotgenous spread to distant sites
   - bone lesions occur