Postradiation prostatic carcinoma

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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]


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




  • Nuclear enlargement and prominent nucleoli are prevalent in radiation changes of the prostate. These features are not useful in this context.[1]






  • AMACR +ve.
  • CK5/6 -ve.
  • p63 -ve.


See also


  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.