Postradiation prostatic carcinoma
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]
- 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
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.
IHC
- AMACR +ve.
- CK5/6 -ve.
- p63 -ve.
See also
References
- ↑ 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.
- ↑ 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.