SM_237b: Pathology of the Prostate Flashcards
Most prostate cancer is ___
Most prostate cancer is adenocarcinoma
____ is the gold standard for diagnosis of prostate cancer
Prostate needle core biopsy w/ 12 cores at 6 locations is the gold standard for diagnosis of prostate cancer
Prostatic gland consists primarily of ___
Prostatic gland consists primarily of epithelial cells
- Secretory cells
- Basal cells
- Neuroendocrine cells
Describe diagnostic features of prostatic adenocarcinoma
Prostatic adenocarcinoma diagnostic features
- Architectural: small glands, infiltrating, straight luminal borders, no basal cells, retraction
- Extracellular material: blue mucin, crystalloids, pink secretion
- Cytological: prominent nucleoli, nuclear enlargement, hyperchromasia, amphophilic cytoplasm, mitosis
- Special structures: perineural invasion, collagenous micronodules, glomeruloid structures, capsule invasion
____, ____, and ____ are key histological features of prostatic adenocarcinoma
Small glands, infiltrating patterns, and prominent nucleoli are key histological features of prostatic adenocarcinoma
Perineural invasion of prostatic adenocarcinoma predicts ___
Perineural invasion of prostatic adenocarcinoma predicts extraprostatic extension
Prostate specific antigen is secreted by ___
Prostate specific antigen is secreted by luminal cells of prostate
____ occurs in prostatic adenocarcinoma
Loss of basal cells occurs in prostatic adenocarcinoma
____ is an essential enzyme for beta-oxidation of branched chain fatty acids that is a new prostate cancer marker
Alpha-methylacyl-CoA racemase (AMACR) is an essential enzyme for beta-oxidation of branched chain fatty acids that is a new prostate cancer marker
- Possible relation to high fat diet
This is ___
This is prostate adenocarcinoma
Describe the Gleason Grading System for prostate
Gleason Grading System for prostate
- Based on cell differentiation (architecture)
- Correlates well with prognosis
- Grade 1-5
- Score 2-10
- Gleason score is sum of predominant pattern and second most prevalent pattern
This is Gleason ____
This is Gleason grade 1
This is Gleason ____
This is Gleason grade 2
This is Gleason ____
This is Gleason grade 3
This is Gleason ____
This is Gleason grade 4 (fused glands)
This is Gleason ____
This is Gleason grade 4
This is Gleason ____
This is Gleason grade 5 (single cells)
This is Gleason ____
This is Gleason grade 5 (solid sheet)
This is Gleason ____
This is Gleason grade 5 (comedo)
Lower Gleason score has ___ prognosis
Lower Gleason score has better prognosis
- 4+3 is worse than 3+4
High grade prostatic intraepithelial neoplasia is ___
High grade prostatic intraepithelial neoplasia is neoplasm cells growing within pre-existing glands (ducts and acini)
- Non-invasive neoplastic lesion
- Precursor lesion of prostate cancer
This is ___ of prostate
This is basal cell carcinoma of prostate
Describe ductal adenocarcinoma of prostate
Ductal adenocarcinoma of prostate
- “Endometrioid carcinoma”
- Histological variant of prostatic adenocarcinoma
- Tall columnar tumor cell
- Equivalent to Gleason pattern 4
- Androgen receptor positive and PSA positive
Describe small cell carcinoma of prostate
Small cell carcinoma of prostate
- More than 50% of cases associated with prostatic adenocarcinoma
- “Oat cell carcinoma”
- Neuroendocrine differentiation
- Aggressive systemic disease requiring special treatment
Describe primary urothelial carcinoma of prostate
Pimary urothelial carcinoma of prostate
- Derived from urothelium of prostatic urethra
- Morphologically similar to urothelial carcinoma of bladder
- Do not respond to hormonal therapy
Describe benign prostatic hyperplasia
Benign prostatic hyperplasia
- Hyperplasia: increase in number of cells
- Enlarged prostate
- Multiple nodules mostly located in transition zone
- Compressed prostatic urethra
Benign prostatic hyperplasia involves ____ and components of ____ and ____
Benign prostatic hyperplasia involves nodular cell proliferation and components of glandular epithelial cells and stromal cells
This is ____
This is prostatic infarct and associated squamous metaplasia
Describe non-specific granulomatous prostatitis
Non-specific granulomatous prostatitis
- Hard nodules on digital exam
- Mixed inflammatory cells around ducts
- Epithelioid histiocytes
- True granuloma may not be obvious
Describe pathological staging of prostate cancer
Pathological staging of prostate cancer
- T2: confined within prostate
- T3: outside prostatic capsule (T3A) or in seminal vesicles (T3B)
Surgical margins or volume of tumor can also be used to evaluate extent of cancer
This is stage ___
This is stage T3a prostatic adenocarcinoma
This is stage ___
This is stage T3b prostatic adenocarcinoma
These are ____
These are metastatic prostate adenocarcinoma
