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.


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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.
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Note:
Note:
*Nuclear enlargement and nucleoli are prevalent in [[radiation changes]] of the prostate. These features are not useful in this context.<ref name=pmid10524518/>
*Nuclear enlargement and prominent [[nucleoli]] are prevalent in [[radiation changes]] of the prostate. These features are not useful in this context.<ref name=pmid10524518/>


DDx:
DDx:
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*Postradiation prostatic sarcoma.<ref name=pmid11763492>{{Cite journal  | last1 = Canfield | first1 = SE. | last2 = Gans | first2 = TH. | last3 = Unger | first3 = P. | last4 = Hall | first4 = SJ. | title = Postradiation prostatic sarcoma: de novo carcinogenesis or dedifferentiation of prostatic adenocarcinoma? | journal = Tech Urol | volume = 7 | issue = 4 | pages = 294-5 | month = Dec | year = 2001 | doi =  | PMID = 11763492 }}</ref>
*Postradiation prostatic sarcoma.<ref name=pmid11763492>{{Cite journal  | last1 = Canfield | first1 = SE. | last2 = Gans | first2 = TH. | last3 = Unger | first3 = P. | last4 = Hall | first4 = SJ. | title = Postradiation prostatic sarcoma: de novo carcinogenesis or dedifferentiation of prostatic adenocarcinoma? | journal = Tech Urol | volume = 7 | issue = 4 | pages = 294-5 | month = Dec | year = 2001 | doi =  | PMID = 11763492 }}</ref>
*[[Sarcomatoid prostatic carcinoma]] - may arise following radiation.
*[[Sarcomatoid prostatic carcinoma]] - may arise following radiation.
===Images===
====Case====
<gallery>
Image: Prostatic carcinoma and radiation changes -- intermed mag.jpg | PC and RC - intermed. mag.
Image: Prostatic carcinoma and radiation changes - alt -- intermed mag.jpg | PC and RC - intermed. mag.
Image: Prostatic carcinoma and radiation changes -- high mag.jpg | PC and RC - high mag.
Image: Prostatic carcinoma and radiation changes -- very high mag.jpg | PC and RC - very high mag.
Image: Radiation changes in the prostate - alt -- high mag.jpg | RC - high mag.
Image: Radiation changes in the prostate - alt -- very high mag.jpg | RC - very high mag.
</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==
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*CK5/6 -ve.
*CK5/6 -ve.
*p63 -ve.
*p63 -ve.
===Images===
<gallery>
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 (AMACR-CK5/6) - intermed. mag.
Image: Prostatic carcinoma and radiation changes - IHC -- high mag.jpg | PC and RC (AMACR-CK5/6) - high mag.
</gallery>


==See also==
==See also==
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{{Reflist|2}}
{{Reflist|2}}


[[Category:Prostate cancer]]
[[Category:Prostate carcinoma]]

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

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

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

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. ↑ 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.
  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.
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