Difference between revisions of "Postradiation prostatic carcinoma"
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'''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> | {{ 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 a type of [[postradiation prostate cancer]]. It 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> | |||
==General== | ==General== | ||
*Overcall and undercall are both seen.<ref name=pmid10524518/> | *Overcall and undercall are both seen.<ref name=pmid10524518/> | ||
*Commonly missed on core biopsies. | *Commonly missed on core biopsies.<ref name=pmid10524518/> | ||
*History of radiation. | *History of radiation. | ||
| Line 9: | Line 40: | ||
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. | ||
| Line 25: | Line 56: | ||
===Images=== | ===Images=== | ||
====Case==== | |||
<gallery> | <gallery> | ||
Image: Prostatic carcinoma and radiation changes -- intermed mag.jpg | PC and RC - intermed. mag. | Image: Prostatic carcinoma and radiation changes -- intermed mag.jpg | PC and RC - intermed. mag. | ||
| Line 34: | Line 66: | ||
Image: Radiation changes in the prostate - alt -- very high mag.jpg | RC - very high mag. | Image: Radiation changes in the prostate - alt -- very high mag.jpg | RC - very high mag. | ||
</gallery> | </gallery> | ||
====www==== | |||
*[http://webpathology.com/image.asp?case=97&n=6 Prostate cancer with radiation changes (webpathology.com)]. | |||
*[http://webpathology.com/image.asp?case=97&n=7 Prostate cancer with radiation changes (webpathology.com)]. | |||
==IHC== | ==IHC== | ||
| Line 42: | Line 78: | ||
===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: Prostatic carcinoma and radiation changes - IHC -- low mag.jpg | PC and RC - low mag. | Image: Prostatic carcinoma and radiation changes - IHC -- low mag.jpg | PC and RC (AMACR-CK5/6) - low mag. | ||
Image: Prostatic carcinoma and radiation changes - IHC -- intermed mag.jpg | PC and RC - intermed. mag. | Image: Prostatic carcinoma and radiation changes - IHC -- intermed mag.jpg | PC and RC (AMACR-CK5/6) - intermed. mag. | ||
Image: Prostatic carcinoma and radiation changes - IHC -- high mag.jpg | PC and RC - high mag. | Image: Prostatic carcinoma and radiation changes - IHC -- high mag.jpg | PC and RC (AMACR-CK5/6) - high mag. | ||
</gallery> | </gallery> | ||
Latest revision as of 17:56, 24 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 a type of postradiation prostate cancer. It is uncommon but may be challenging to diagnose.[1]
General
Microscopic
Features:[1]
- Infiltrative growth (diagnostic).
- Perineural invasion (diagnostic).
- Intraluminal crystalloids.
- Blue mucin secretions.
- Absence of corpora amylacea.
- Coexistent high-grade prostatic intraepithelial neoplasia.
Note:
- Nuclear enlargement and prominent nucleoli are prevalent in radiation changes of the prostate. These features are not useful in this context.[1]
DDx:
- Radiation changes.
- Pleomorphic tumours.
- Postradiation prostatic sarcoma.[2]
- Sarcomatoid prostatic carcinoma - may arise following radiation.
Images
Case
PC and RC - intermed. mag.
PC and RC - intermed. mag.
PC and RC - high mag.
PC and RC - very high mag.
RC - high mag.
RC - very high mag.
www
- Prostate cancer with radiation changes (webpathology.com).
- Prostate cancer with radiation changes (webpathology.com).
IHC
- AMACR +ve.
- CK5/6 -ve.
- p63 -ve.
Images
PC and RC (AMACR-CK5/6) - low mag.
PC and RC (AMACR-CK5/6) - intermed. mag.
PC and RC (AMACR-CK5/6) - high mag.
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 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.
- ↑ 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.