Difference between revisions of "Postradiation prostatic carcinoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Prostatic carcinoma and radiation changes -- high mag.jpg
| Width      =
| Caption    = Prostatic carcinoma (pale glands - left/bottom of image) and radiation changes (hyperchromatic glands with nuclear atypia (upper right of image). [[H&E stain]].
| Synonyms  =
| Micro      = infiltrative growth, perineural invasion, blue mucin secretions, intraluminal crystalloids
| Subtypes  =
| LMDDx      = [[radiation changes]], [[pleomorphic tumours]], postradiation prostatic sarcoma, [[sarcomatoid prostatic carcinoma]]
| Stains    =
| IHC        = AMACR +ve, CK5/6 -ve, p63 -ve, PSA +ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[prostate gland]]
| Assdx      =
| Syndromes  =
| Clinicalhx = radiation treatment, prostate carcinoma (previously diagnosed)
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  = elevated PSA or increasing PSA
| Rads      =
| Endoscopy  =
| Prognosis  = poor (?)
| Other      =
| ClinDDx    = radiation changes, infection
| Tx        = salvage prostatectomy
}}
'''Postradiation prostatic carcinoma''', also '''prostate carcinoma after radiation therapy''', is uncommon but may be challenging to diagnose.<ref name=pmid10524518>{{Cite journal  | last1 = Cheng | first1 = L. | last2 = Cheville | first2 = JC. | last3 = Bostwick | first3 = DG. | title = Diagnosis of prostate cancer in needle biopsies after radiation therapy. | journal = Am J Surg Pathol | volume = 23 | issue = 10 | pages = 1173-83 | month = Oct | year = 1999 | doi =  | PMID = 10524518 }}</ref>
'''Postradiation prostatic carcinoma''', also '''prostate carcinoma after radiation therapy''', is uncommon but may be challenging to diagnose.<ref name=pmid10524518>{{Cite journal  | last1 = Cheng | first1 = L. | last2 = Cheville | first2 = JC. | last3 = Bostwick | first3 = DG. | title = Diagnosis of prostate cancer in needle biopsies after radiation therapy. | journal = Am J Surg Pathol | volume = 23 | issue = 10 | pages = 1173-83 | month = Oct | year = 1999 | doi =  | PMID = 10524518 }}</ref>


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Features:<ref name=pmid10524518/>
Features:<ref name=pmid10524518/>
*Infiltrative growth (diagnostic).
*Infiltrative growth (diagnostic).
*Perineural invasion (diagnostic).
*[[Perineural invasion]] (diagnostic).
*Intraluminal crystalloids.
*Intraluminal crystalloids.
*Blue mucin secretions.
*Blue mucin secretions.

Revision as of 05:12, 23 July 2015

Postradiation prostatic carcinoma
Diagnosis in short

Prostatic carcinoma (pale glands - left/bottom of image) and radiation changes (hyperchromatic glands with nuclear atypia (upper right of image). H&E stain.

LM infiltrative growth, perineural invasion, blue mucin secretions, intraluminal crystalloids
LM DDx radiation changes, pleomorphic tumours, postradiation prostatic sarcoma, sarcomatoid prostatic carcinoma
IHC AMACR +ve, CK5/6 -ve, p63 -ve, PSA +ve
Site prostate gland

Clinical history radiation treatment, prostate carcinoma (previously diagnosed)
Prevalence uncommon
Blood work elevated PSA or increasing PSA
Prognosis poor (?)
Clin. DDx radiation changes, infection
Treatment salvage prostatectomy

Postradiation prostatic carcinoma, also prostate carcinoma after radiation therapy, is uncommon but may be challenging to diagnose.[1]

General

  • Overcall and undercall are both seen.[1]
  • Commonly missed on core biopsies.
  • History of radiation.

Microscopic

Features:[1]

Note:

  • Nuclear enlargement and prominent nucleoli are prevalent in radiation changes of the prostate. These features are not useful in this context.[1]

DDx:

Images

IHC

  • AMACR +ve.
  • CK5/6 -ve.
  • p63 -ve.

Images

See also

References

  1. 1.0 1.1 1.2 1.3 Cheng, L.; Cheville, JC.; Bostwick, DG. (Oct 1999). "Diagnosis of prostate cancer in needle biopsies after radiation therapy.". Am J Surg Pathol 23 (10): 1173-83. PMID 10524518.
  2. Canfield, SE.; Gans, TH.; Unger, P.; Hall, SJ. (Dec 2001). "Postradiation prostatic sarcoma: de novo carcinogenesis or dedifferentiation of prostatic adenocarcinoma?". Tech Urol 7 (4): 294-5. PMID 11763492.