Difference between revisions of "Prostate cancer"

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===Prostatectomy grossing===
===Prostatectomy grossing===
There is a consensus paper on grossing by the ''ISUP'':<ref name=pmid20834234>{{Cite journal  | last1 = Samaratunga | first1 = H. | last2 = Montironi | first2 = R. | last3 = True | first3 = L. | last4 = Epstein | first4 = JI. | last5 = Griffiths | first5 = DF. | last6 = Humphrey | first6 = PA. | last7 = van der Kwast | first7 = T. | last8 = Wheeler | first8 = TM. | last9 = Srigley | first9 = JR. | title = International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 1: specimen handling. | journal = Mod Pathol | volume = 24 | issue = 1 | pages = 6-15 | month = Jan | year = 2011 | doi = 10.1038/modpathol.2010.178 | PMID = 20834234 }}</ref>
There are several consensus papers on grossing by the ''ISUP''.
*[[Embedding in toto]] is not required.
*Prostate gland:<ref name=pmid20834234>{{Cite journal  | last1 = Samaratunga | first1 = H. | last2 = Montironi | first2 = R. | last3 = True | first3 = L. | last4 = Epstein | first4 = JI. | last5 = Griffiths | first5 = DF. | last6 = Humphrey | first6 = PA. | last7 = van der Kwast | first7 = T. | last8 = Wheeler | first8 = TM. | last9 = Srigley | first9 = JR. | title = International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 1: specimen handling. | journal = Mod Pathol | volume = 24 | issue = 1 | pages = 6-15 | month = Jan | year = 2011 | doi = 10.1038/modpathol.2010.178 | PMID = 20834234 }}</ref>
**A study by Epstein suggests it is reasonable to submit all of the posterior aspect and selected sections from the mid portion.<ref name=pmid11381367>{{Cite journal  | last1 = Sehdev | first1 = AE. | last2 = Pan | first2 = CC. | last3 = Epstein | first3 = JI. | title = Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma. | journal = Hum Pathol | volume = 32 | issue = 5 | pages = 494-9 | month = May | year = 2001 | doi = 10.1053/hupa.2001.24322 | PMID = 11381367 }}</ref>
**[[Embedding in toto]] is not required.
*The prostate should be painted -- to mark the margins.
***A study by Epstein suggests it is reasonable to submit all of the posterior aspect and selected sections from the mid portion.<ref name=pmid11381367>{{Cite journal  | last1 = Sehdev | first1 = AE. | last2 = Pan | first2 = CC. | last3 = Epstein | first3 = JI. | title = Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma. | journal = Hum Pathol | volume = 32 | issue = 5 | pages = 494-9 | month = May | year = 2001 | doi = 10.1053/hupa.2001.24322 | PMID = 11381367 }}</ref>
*Sectioning should be done after fixation.
**The prostate should be painted -- to mark the margins.
*The prostate should be weighted after fixation and trimming of the seminal vesicles.
**Sectioning should be done after fixation.
*The apex of the prostate and the bladder neck should be sliced-off, sagittally sectioned, and submitted separately on edge (to assess the margin).
**The prostate should be weighted after fixation and trimming of the seminal vesicles.
 
**The apex of the prostate and the bladder neck should be sliced-off, sagittally sectioned, and submitted separately on edge (to assess the margin).
Other:
*Lymph nodes and seminal vesicles (SV):<ref name=pmid20818343>{{Cite journal  | last1 = Berney | first1 = DM. | last2 = Wheeler | first2 = TM. | last3 = Grignon | first3 = DJ. | last4 = Epstein | first4 = JI. | last5 = Griffiths | first5 = DF. | last6 = Humphrey | first6 = PA. | last7 = van der Kwast | first7 = T. | last8 = Montironi | first8 = R. | last9 = Delahunt | first9 = B. | title = International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 4: seminal vesicles and lymph nodes. | journal = Mod Pathol | volume = 24 | issue = 1 | pages = 39-47 | month = Jan | year = 2011 | doi = 10.1038/modpathol.2010.160 | PMID = 20818343 }}</ref>
*All fat should associated with lymph nodes should be submitted, as metastases are found in over 5% of tissue not grossly recognized as a lymph node.<ref name=pmid3773097>{{Cite journal  | last1 = Epstein | first1 = JI. | last2 = Oesterling | first2 = JE. | last3 = Eggleston | first3 = JC. | last4 = Walsh | first4 = PC. | title = Frozen section detection of lymph node metastases in prostatic carcinoma: accuracy in grossly uninvolved pelvic lymphadenectomy specimens. | journal = J Urol | volume = 136 | issue = 6 | pages = 1234-7 | month = Dec | year = 1986 | doi =  | PMID = 3773097 }}</ref>
**All lymph nodes should be submitted.
***Metastases are found in over 5% of tissue not grossly recognized as a lymph node;<ref name=pmid3773097>{{Cite journal  | last1 = Epstein | first1 = JI. | last2 = Oesterling | first2 = JE. | last3 = Eggleston | first3 = JC. | last4 = Walsh | first4 = PC. | title = Frozen section detection of lymph node metastases in prostatic carcinoma: accuracy in grossly uninvolved pelvic lymphadenectomy specimens. | journal = J Urol | volume = 136 | issue = 6 | pages = 1234-7 | month = Dec | year = 1986 | doi =  | PMID = 3773097 }}</ref> thus, it makes sense to submit all tissue.
**The base of the SV/prostate junction must be submitted.
***SV does ''not'' have to be submitted in total.


==Microscopic==
==Microscopic==
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