Prostate Pathology Flashcards
4 components of glandular compartment of prostate
peripheral, central, transitional, periurethral
non glandular compartments of prostate
anterior fibromuscular stroma, preprostatic sphincter
the ____ is anteriorly concave
urethra
The ejaculatory duct passes through the ____ zone.
central
The prostatic urethra passes through the ____ zone
transitional zone
70-80% of prostate cancers arise from the ____ zone
peripheral
T/F Some prostatic cancers arise in the central zone.
F –> cancers do not arise in central zone…only secondarily involved
Benign prostatic hyperplasia localizes to the ___ zone which is also where ____ % of cancers arise
transition and 10-20%
2 layers of prostatic duct lobules
secretory cells (cuboidal/columnar) and basal cells
nodular prostate enlargement due to cellular proliferations of prostatic glands and stroma associated with lower urinary tract symptoms LUTS
BPH
LUTS
BPH
Pathophysiology of BPH
cellular accumulation of testosterone (especially DHT) and some estrogen; risk factors = age and family history
Most common cause of non-cancerous rise in PSA
BPH
Tx of BPH
alpha andrenergic blocker or 5 alpha reductase inhibitor // surgical is best
Hallmark of BPH
suburethral nodular prostatic enlargement –> centered on proximal urethra and involve transitional and submucosal compartment
Which group has highest incidence of prostate carcinoma
african americans in us
T/F there is a strong association between PCA and diets rich in red meat.
T
Gold standard for prostate cancer identification
needle biopsy
Why is most us PCA asymptomatic?
early id due to screening by PSA
Gold standard for clinical staging of PCA?
digital rectal exam (DRE)
Symptoms of PCA
obstructive bladder symptoms, pelvic pain, bone pain due to mets
___ produces PSA
prostate epithelium produces prostate specific antigen
Cutoff for psa biopsy
4 ng/mL
role of PSA
liquifies semen
high/low PSA is associated with more cancer
high
T/F there is no psa cut off at which a man can be guaranteed to be free of prostate cancer
T
T/F prostate cancer does not have a reliably gross mass.
T –> unless quite large(dense appearance, lack necrosis/hemorrhage, no sharp borders)
Architectural features of prostate carcinoma glands
small, crowded, rigid lumen, lack basal cells –> determines gleason grading
Nuclear/cytoplasmic features of prostate cancer
enlarged nuclei, uniform, nonpleomorophic, high mitotic rate
Intraluminal features of prostate cancer
blue mucin, eosinophlic amorphous secretions, crystalloids, intraluminal necrosis
Corpora amylacea vs intraluminal necrosis
intraluminal features: benign vs malignant
4 pathognomic features of prostate cancer
circumferential perineural invasion, collagenous micronodules, glomerulations, growth in adipose tissue
Gleason scale
1-5 –> the pattern by which glands grow (higher is worse) –>most abundant grade + highest grade + some other factors = score
T1 a/b/c stage prostate cancer
incidentally found
T2 stage prostate cancer
a = tumor of <1/2 lobe, b = tumor between 1/2 and 1 lobe, c= tumor of 2 lobes
T3 stage prostate cancer
invasions into fat (a) or seminal vesicles (b)
T4 stage prostate cancer
invasion elsewhere
Most frequent alteration in prostate cancer oncogenome was loss of _______
chromosome 8p
