Difference between revisions of "Prostate cancer"

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Prostate cancer (view source)

Revision as of 04:44, 11 April 2015

3,472 bytes removed ,  04:44, 11 April 2015
→‎Intraductal carcinoma of the prostate: split out
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*[[AKA]] ''[[intraductal carcinoma]]''.
*[[AKA]] ''[[intraductal carcinoma]]''.
*[[AKA]] ''intraductal prostate carcinoma''.
*[[AKA]] ''intraductal prostate carcinoma''.
===General===
{{Main|Intraductal carcinoma of the prostate}}
*Associated with a poor prognosis.<ref name=pmid19246509>{{Cite journal  | last1 = Henry | first1 = PC. | last2 = Evans | first2 = AJ. | title = Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications. | journal = J Clin Pathol | volume = 62 | issue = 7 | pages = 579-83 | month = Jul | year = 2009 | doi = 10.1136/jcp.2009.065003 | PMID = 19246509 }}</ref>
*Strong association with aggressive invasive carcinomas on prostatectomy when identified in isolation on biopsy.<ref name=pmid20723921>{{Cite journal  | last1 = Robinson | first1 = BD. | last2 = Epstein | first2 = JI. | title = Intraductal carcinoma of the prostate without invasive carcinoma on needle biopsy: emphasis on radical prostatectomy findings. | journal = J Urol | volume = 184 | issue = 4 | pages = 1328-33 | month = Oct | year = 2010 | doi = 10.1016/j.juro.2010.06.017 | PMID = 20723921 }}</ref>
*High interobserver variability among experts ~43% agreement.<ref name=pmid25263387>{{Cite journal  | last1 = Iczkowski | first1 = KA. | last2 = Egevad | first2 = L. | last3 = Ma | first3 = J. | last4 = Harding-Jackson | first4 = N. | last5 = Algaba | first5 = F. | last6 = Billis | first6 = A. | last7 = Camparo | first7 = P. | last8 = Cheng | first8 = L. | last9 = Clouston | first9 = D. | title = Intraductal carcinoma of the prostate: interobserver reproducibility survey of 39 urologic pathologists. | journal = Ann Diagn Pathol | volume = 18 | issue = 6 | pages = 333-42 | month = Dec | year = 2014 | doi = 10.1016/j.anndiagpath.2014.08.010 | PMID = 25263387 }}</ref>
**For comparison: HGPIN ~70% agreement, invasive carcinoma ~73% agreement.
 
===Microscopic===
====Major criteria====
Required major criteria:<ref name=pmid22692290>{{Cite journal  | last1 = Shah | first1 = RB. | last2 = Zhou | first2 = M. | title = Atypical cribriform lesions of the prostate: clinical significance, differential diagnosis and current concept of intraductal carcinoma of the prostate. | journal = Adv Anat Pathol | volume = 19 | issue = 4 | pages = 270-8 | month = Jul | year = 2012 | doi = 10.1097/PAP.0b013e31825c6c0e | PMID = 22692290 }}</ref><ref name=pmid17616999>{{Cite journal  | last1 = Cohen | first1 = RJ. | last2 = Wheeler | first2 = TM. | last3 = Bonkhoff | first3 = H. | last4 = Rubin | first4 = MA. | title = A proposal on the identification, histologic reporting, and implications of intraductal prostatic carcinoma. | journal = Arch Pathol Lab Med | volume = 131 | issue = 7 | pages = 1103-9 | month = Jul | year = 2007 | doi = 10.1043/1543-2165(2007)131[1103:APOTIH]2.0.CO;2 | PMID = 17616999 }}</ref>
#Glands 2x normal (peripheral zone) glands.
#Basal cells present (proven by IHC).
#"Cytologically malignant cells" = nuclear hyperchromasia, nuclear enlargement, nucleoli.
#Fills the lumen ("expansile") but does not have to be "solid".
#*Solid = no spaces between the cells.
 
Additional (major) criterion:<ref name=pmid22692290/>
*Comedo[[necrosis]].
 
====Minor criteria====
Minor criteria:<ref name=pmid22692290/>
#Branching of ducts at right angles.
#Rounded/smooth gland outlines.
#Two cell populations:
#*Malignant population (enlarged nuclei with hyperchromasia and nucleoli) = peripheral location in gland.
#*Benign population (smaller nuclei, no nucleoli) = central location in gland.
 
DDx:
*[[High-grade prostatic intraepithelial neoplasia]] (HGPIN).
*Invasive [[prostate adenocarcinoma]].
 
===IHC===
Features - basal cells present:
*CK34betaE12 +ve.
*p63 +ve.


=Unusual forms of prostate cancer=
=Unusual forms of prostate cancer=
Michael
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