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Difference between revisions of "Prostate cancer"
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→Lymph node metastases
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*Essentially never happens in Gleason score 6 cancers. | *Essentially never happens in Gleason score 6 cancers. | ||
**A study of over 14,000 Gleason score <=6 cases found 22 cases with lymph node metastases -- all of the 19 cases available for review were determined to have a higher Gleason score and some Gleason pattern 4 or 5.<ref name=pmid22531173>{{Cite journal | last1 = Ross | first1 = HM. | last2 = Kryvenko | first2 = ON. | last3 = Cowan | first3 = JE. | last4 = Simko | first4 = JP. | last5 = Wheeler | first5 = TM. | last6 = Epstein | first6 = JI. | title = Do adenocarcinomas of the prostate with Gleason score (GS) ≤6 have the potential to metastasize to lymph nodes? | journal = Am J Surg Pathol | volume = 36 | issue = 9 | pages = 1346-52 | month = Sep | year = 2012 | doi = 10.1097/PAS.0b013e3182556dcd | PMID = 22531173 }}</ref> | **A study of over 14,000 Gleason score <=6 cases found 22 cases with lymph node metastases -- all of the 19 cases available for review were determined to have a higher Gleason score and some Gleason pattern 4 or 5.<ref name=pmid22531173>{{Cite journal | last1 = Ross | first1 = HM. | last2 = Kryvenko | first2 = ON. | last3 = Cowan | first3 = JE. | last4 = Simko | first4 = JP. | last5 = Wheeler | first5 = TM. | last6 = Epstein | first6 = JI. | title = Do adenocarcinomas of the prostate with Gleason score (GS) ≤6 have the potential to metastasize to lymph nodes? | journal = Am J Surg Pathol | volume = 36 | issue = 9 | pages = 1346-52 | month = Sep | year = 2012 | doi = 10.1097/PAS.0b013e3182556dcd | PMID = 22531173 }}</ref> | ||
====Perineural invasion==== | |||
{{Main|Perineural invasion}} | |||
*''Not'' a staging parameter. | |||
*Seen in approximately 20% of core biopsies.<ref name=pmid16096404>{{Cite journal | last1 = Ali | first1 = TZ. | last2 = Epstein | first2 = JI. | title = Perineural involvement by benign prostatic glands on needle biopsy. | journal = Am J Surg Pathol | volume = 29 | issue = 9 | pages = 1159-63 | month = Sep | year = 2005 | doi = | PMID = 16096404 }}</ref> | |||
*Complete wrapping of a nerve by epithelium is considered pathognomonic for cancer.<ref name=pmid10435561>{{Cite journal | last1 = Baisden | first1 = BL. | last2 = Kahane | first2 = H. | last3 = Epstein | first3 = JI. | title = Perineural invasion, mucinous fibroplasia, and glomerulations: diagnostic features of limited cancer on prostate needle biopsy. | journal = Am J Surg Pathol | volume = 23 | issue = 8 | pages = 918-24 | month = Aug | year = 1999 | doi = | PMID = 10435561 }}</ref><ref name=pmid16096404/> | |||
Note: | |||
*Occasionally, benign glands are found perineural.<ref name=pmid16096404/> | |||
**These should ''not'' completely wrap around the nerve and cytologically should be benign. | |||
==IHC== | ==IHC== | ||