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Difference between revisions of "Prostate gland"
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**Second cell layer may be difficult to see (like in breast). | **Second cell layer may be difficult to see (like in breast). | ||
*Epithelium in glands is "folded" or "tufted". | *Epithelium in glands is "folded" or "tufted". | ||
**Very important - helps | **Very important - helps to differentiate from Gleason pattern 3. | ||
*Luminal epithelium often clear cytoplasm. | *Luminal epithelium often clear cytoplasm. | ||
*Single nucleus. | *Single nucleus. | ||
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Notes: | Notes: | ||
*Tufted epithelium is a strong indicator of benignancy; however two uncommon prostate cancer typically have tufted epithelium: | *Tufted epithelium is a strong indicator of benignancy; however two uncommon prostate cancer variants typically have tufted epithelium: | ||
**[[Pseudohyperplastic adenocarcinoma]]. | **[[Pseudohyperplastic adenocarcinoma]]. | ||
**[[Foamy gland carcinoma]]. | **[[Foamy gland carcinoma]]. | ||
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Normal prostate: | Normal prostate: | ||
*[[AMACR]] -ve (mark epithelial cells). | *[[AMACR]] -ve (mark epithelial cells). | ||
*CK5/6 +ve,<ref name=pmid19605815>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Bartczak-McKay | first2 = J. | last3 = Yilmaz | first3 = A. | title = Usefulness of cytokeratin 5/6 and AMACR applied as double sequential immunostains for diagnostic assessment of problematic prostate specimens. | journal = Am J Clin Pathol | volume = 132 | issue = 2 | pages = 211-20; quiz 307 | month = Aug | year = 2009 | doi = 10.1309/AJCPGFJP83IXZEUR | PMID = 19605815 }}</ref> p63 +ve, HMWCK +ve (mark basal cells). | *[[CK5/6]] +ve,<ref name=pmid19605815>{{Cite journal | last1 = Trpkov | first1 = K. | last2 = Bartczak-McKay | first2 = J. | last3 = Yilmaz | first3 = A. | title = Usefulness of cytokeratin 5/6 and AMACR applied as double sequential immunostains for diagnostic assessment of problematic prostate specimens. | journal = Am J Clin Pathol | volume = 132 | issue = 2 | pages = 211-20; quiz 307 | month = Aug | year = 2009 | doi = 10.1309/AJCPGFJP83IXZEUR | PMID = 19605815 }}</ref> p63 +ve, HMWCK +ve (mark basal cells). | ||
*PSA (prostate-specific antigen) +ve, PSAP (prostatic-specific acid phosphatase) +ve. | *PSA ([[prostate-specific antigen]]) +ve, PSAP ([[prostatic-specific acid phosphatase]]) +ve. | ||
==Sign out== | ==Sign out== | ||
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==Common diagnoses== | ==Common diagnoses== | ||
*Benign. | *Benign. | ||
**[[ | **[[Atrophy of the prostate|Atrophy]] - may resemble adenocarcinoma - typically not reported. | ||
**Adenosis - may resemble adenocarcinoma - typically not reported. | **[[Adenosis of the prostate|Adenosis]] - may resemble adenocarcinoma - typically not reported. | ||
*[[Prostate adenocarcinoma]]. | *[[Prostate adenocarcinoma]]. | ||
*[[HGPIN]] (high-grade prostatic intraepithelial neoplasia) - prostate adenocarcinoma precursor lesion. | *[[HGPIN]] (high-grade prostatic intraepithelial neoplasia) - prostate adenocarcinoma precursor lesion. | ||
*[[ASAP]] (atypical small acinar proliferation) - used if you have a few abnormal appearing glands... but can't decide between prostate adenocarcinoma & benign. | *[[ASAP]] (atypical small acinar proliferation) - used if you have a few abnormal appearing glands... but can't decide between prostate adenocarcinoma & benign. | ||
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*HIFU = ''High Intensity Focused Ultrasound'' - an ablation procedure for prostate cancer.<ref>URL: [http://www.internationalhifu.com/what-is-hifu-mainmenu-132.html http://www.internationalhifu.com/what-is-hifu-mainmenu-132.html]. Accessed on: 15 June 2010.</ref> | *HIFU = ''High Intensity Focused Ultrasound'' - an ablation procedure for prostate cancer.<ref>URL: [http://www.internationalhifu.com/what-is-hifu-mainmenu-132.html http://www.internationalhifu.com/what-is-hifu-mainmenu-132.html]. Accessed on: 15 June 2010.</ref> | ||
= | =Benign changes and remnants= | ||
==Adenosis of the prostate gland== | |||
*[[AKA]] ''atypical adenomatous hyperplasia of the prostate gland'' (or ''atypical adenomatous hyperplasia''). | |||
{{Main|Adenosis of the prostate gland}} | |||
==Basal cell hyperplasia of the prostate== | |||
{{Main|Basal cell hyperplasia of the prostate}} | |||
==Atrophy of the prostate== | |||
*[[AKA]] ''atrophy''. | |||
*[[AKA]] ''prostatic atrophy''. | |||
*[[AKA]] ''atrophy of the prostate gland''. | |||
{{Main|Atrophy of the prostate gland}} | |||
==Mesonephric remnant of the prostate gland== | |||
{{Main|Mesonephric remnant of the prostate gland}} | |||
=Benign conditions= | |||
==Prostatic nodular hyperplasia== | ==Prostatic nodular hyperplasia== | ||
*[[AKA]] ''nodular hyperplasia of the prostate''. | *[[AKA]] ''nodular hyperplasia of the prostate''. | ||
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==Granulomatous prostatitis== | ==Granulomatous prostatitis== | ||
{{Main|Granulomatous prostatitis}} | {{Main|Granulomatous prostatitis}} | ||
==Prostatic infarct== | ==Prostatic infarct== | ||
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*[http://www.sciencephoto.com/media/258565/enlarge Prostatic thrombosis (sciencephoto.com)]. | *[http://www.sciencephoto.com/media/258565/enlarge Prostatic thrombosis (sciencephoto.com)]. | ||
== | =Preneoplastic changes and atypical changes= | ||
==High-grade prostatic intraepithelial neoplasia== | ==High-grade prostatic intraepithelial neoplasia== | ||
*Abbreviated as ''HGPIN''. | *Abbreviated as ''HGPIN''. | ||
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**''ASAP'' is preferred as it does not contain the word ''carcinoma'' and, thus, cannot be misread as ''carcinoma'', i.e. positive for malignancy. | **''ASAP'' is preferred as it does not contain the word ''carcinoma'' and, thus, cannot be misread as ''carcinoma'', i.e. positive for malignancy. | ||
{{Main|Atypical small acinar proliferation}} | {{Main|Atypical small acinar proliferation}} | ||
=Prostate cancer= | =Prostate cancer= | ||