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Difference between revisions of "Prostate gland"
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==Cancer== | ==Cancer== | ||
===Criteria as a list=== | |||
Major criteria:<ref name=pmid17213347>{{cite journal |author=Humphrey PA |title=Diagnosis of adenocarcinoma in prostate needle biopsy tissue |journal=J. Clin. Pathol. |volume=60 |issue=1 |pages=35–42 |year=2007 |month=January |pmid=17213347 |pmc=1860598 |doi=10.1136/jcp.2005.036442 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860598/?tool=pubmed}}</ref> | |||
#"Infiltrative growth" pattern. | |||
#Lack of basal cells. | |||
#Nuclear atypia (nuclear enlargement). | |||
#Nucleoli. | |||
===Low power features=== | ===Low power features=== | ||
*Architecture is the key to diagnosing low grade cancer. | *Architecture is the key to diagnosing low grade cancer. | ||
**Back-to-back glands or crowding of glands -- think low grade cancer (Gleason pattern 3). | **Back-to-back glands or crowding of glands -- think low grade cancer (Gleason pattern 3). | ||
**Sharp | **Sharp transition between gland border and lumen. | ||
***Loss of epithelial folding at the epithelium-gland lumen interface - "punched-out" appearance. | ***Loss of epithelial folding at the epithelium-gland lumen interface - "punched-out" appearance. | ||
**Eosinophilic proteinaceous debris within the gland lumen. | **Eosinophilic proteinaceous debris within the gland lumen. | ||
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*Nuclei. | *Nuclei. | ||
**Hyperchromatic nuclei (like in HGPIN). | **Hyperchromatic nuclei (like in HGPIN). | ||
** | **Nuclear largement. | ||
***Difficult to appreciate (if cancer isn't side-by-side with normal prostate). | ***Difficult to appreciate (if cancer isn't side-by-side with normal prostate). | ||
***Difficult to see if not on high power. | ***Difficult to see if not on high power. | ||
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***One should not use 400x to look for nucleoli (it is a waste of time + you risk overcalling something benign). | ***One should not use 400x to look for nucleoli (it is a waste of time + you risk overcalling something benign). | ||
**If I see three good nucleoli in a gland I'm usually confident it is cancer. | **If I see three good nucleoli in a gland I'm usually confident it is cancer. | ||
*Loss of basal cells - diagnostic feature. | |||
**Like in breast pathology (where one looks for loss of myoepithelial cells) - this may be difficult to see. | |||
Notes: | Notes: | ||
*Mitoses are not a common feature | *Mitoses are not a common feature - don't waste time looking for them. | ||
===IHC=== | ===IHC=== | ||
*AMACR+, p63-, HMWCK-. | *AMACR +ve, p63 -ve, HMWCK (34betaE12) -ve . | ||
*Usually positive: PSA, PSAP. | *Usually positive: PSA, PSAP. | ||