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GenitoUrinary Tract > Prostate > Flashcards

Prostate Flashcards

1
Q

MC infectious cause of prostatitis

A

E. Coli
Enterococcus

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2
Q

T or F: acute prostatitis causes clinically elevated PSA

A

True

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3
Q

MC site of metastasis of acinar prostate adenocarcinoma and what type

A

Bone (MC: lumbar spine) - osteoblastic

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4
Q

T or F: IHC useful to disprove cancer, not prove cancer

A

True

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5
Q

T or F: tumors showing treatment effect (androgen deprivation or radiation therapy) are not graded

A

True

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6
Q

What is the importance of recording percentage of pattern 4 in Gleason score 7?

A

3+4 with a small amount of pattern 4 (less than or equal to 10%) may be eligible for active surveillance

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7
Q

T or F: in the setting of high grade cancer, ignore low grade cancers if they occupy <5% of the area of the tumor

A

True

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8
Q

T or F: high grade tumor of any quantity should be included

A

True

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9
Q

An early molecular event for development of prostate cancer

A

TMPRSS2-ERG fusion

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10
Q

Presence of this mutation significantly increases risk of prostate cancer

A

BRCA2

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11
Q

What are considered extraprostatic extension?

A

Invading fat
Involving loose connective tissue beyond the plane of the prostate
Involving perineural spaces in the neurovascular bundles
Invasion of UB neck
Seminal vesicle involvement (muscular wall)

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12
Q

A descriptive term used when there us a collection of small glands suspicious for cancer but lack definitive diagnostic features

A

Atypical small acinar proliferation (ASAP)

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13
Q

How many glands are needed to diagnose cancer?

A

No absolute number but at least 3

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14
Q

Architecture of HGPIN

A

Tufting, micropapillary and flat growth pattern

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15
Q

A distinct precursor lesion with high risk of progression to cancer or part of intraductal spread of invasive cancer.
Pattern: solid, dense (>50% Epithelium to luminal space ratio) or loose cribriform and micropapillary pattern
Dx?
Is ihc needed?
Graded?
Prognosis?

A

Intraductal carcinoma (IDC)
Yes to demonstarte basal cells
Not graded
Associated with high gleason grade and tumor volume

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16
Q

Term used if a lumen-spanning atypical lesion morphologically falls short of intraductal carcinoma

A

Atypical intraductal proliferation

17
Q

Subtype of prostatic adenocarcinoma with tall, columnar, pseudostartified epithelium with elongated nuclei arranged in papillary and cribriform architecture in dilated glands (like endometrioid adenocarcinoma)
Grade?
Typical location?
Prognosis?

A

Ductal adenocarcinoma
Pattern 4 but if there is necrosis, grade as 5
Typically periurethral location
More aggressive than acinar adeno, with seminal vesicle invasion and EPE
More likely to be mixed with acinar rather than pure

18
Q

Why is it important to know the location of the urothelial carcinoma that has spread into the prostate?

A

If from bladder: prostate stroma (T4)/ mucosal (T2)
If from prostatic urethra: prostate stroma (T2)

19
Q

Tumor with adenoid/cystic pattern with inspissated secretions and small solid nests with hyaline rim.
(+) p63 outer cells
(+) CK7 luminal cells
HER2 overexpression
Graded?
Behavior?

A

Basal cell carcinoma
GS not used
Aggressive

20
Q

Extremely rare and mostly arise from either divergent differentiation of basal
Cells or transdufferentiation of usual adenocarcinoma following hormonal therapy

A

SCCA

21
Q

A patient with treated prostate cancer came in for monitoring. Biopsy of the prostate showed sheets of small dark blue cells.
(+) synaptophysin
Dx?
Risk factor?
Criteria?

A

Small cell neuroendocrine carcinoma
Treated prostate cancer
Positive in at least 1 NE marker

22
Q

A biopsy of the prostate shows hypercellular stroma with scattered degenerative appearing cells admixed with benign glands
Dx?
Prognosis

A

Stromal tumor of uncertain malignant potential (STUMP)
Good prognosis

23
Q

Proliferation of basal cells and appears blue due to crowded nuclei with scant cytoplasm filling tubules that may form solid nests

A

Basal cell hyperplasia

24
Q

Nodules of clear cells with smooth gland borders. Cells show uniform bland nuclei without prominent nucleoli.
Most often seen in central zone on TURP in BPH

A

Clear cell cribriform hyperplasia

25
Q

Glands with abundant mucin-filled cytoplasm (PASD+) with lobular architecture most often seen in periurethral area near the apex

A

Cowper’s glands

26
Q

Well-circumscribed tightly packed uniform glands with lobular architecture with cells with pale to clear cytoplasm.
Occurs in transition zone.
What is the difficulty encountered in distinguishing from adenocarcinoma?

A

Adenosis/ atypical adenomatous hyperplasia
Basal cells may be decreased in adenosis

27
Q

Lobular or focally infiltrative proliferation of dense spindled stroma and entrapped epithelial elements that lack cytologic atypia.
(+) p63, HMWCK, SMA, s100

A

Sclerosing adenosis

28
Q

The MC benign mimicker of prostatic carcinoma on needle biopsy.
Why is PIN-4 interpretation problematic in this case?

A

Partial atrophy
Because basal cells may be patchy or absent and luminal AMACR reactivity is common

29
Q

Here, there are tightly packed very small cytologically bland glands clustered around a larger dilated “feeder” vessel

A

Post-atrophic hyperplasia (PAH)

30
Q

MC cause of malakoplakia in prostate
Stains for MG bodies?

A

E. Coli
Klebsiella pneumoniae
Von kossa and prussian blue

31
Q

IHC to differentiate seminal vesicle glands and prostate glands

A

CK7 (+) in seminal vesicle glands

32
Q

Hyperplasias mc occur in what zone of the prostate

A

Transition zone

33
Q

MC form of prostatitis

A

Chronic abacterial prostatitis (chronic pelvic pain syndrome)
- prostatic secretions contain >10 leukocytes/hpf but negative culture

34
Q

What is the main androgen in the prostate and how is it formed
Where does it bind
How does it cause BPH

A

Dihydrotestosterone (DHT)
From testosterone through action of type 2 5alpha-reductase (stromal cells)
Type 1 from extraprostatic testosterone
Activates AR receptors in stroma and epithelium —> growth factor production (FGF and TGF-B)—> increase proliferation of stromal cells and decrease the death of epithelial cells
Note: estrogen also contributes

35
Q

BPH affects what zone

A

Inner periurethral zone and transition zone

GenitoUrinary Tract (4 decks)

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