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Difference between revisions of "Prostate cancer"
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*There is no agreed upon minimum number of glands; however, one paper suggests that agreement among experts is low with 5 or less glands.<ref name=pmid20061936>{{Cite journal | last1 = Van der Kwast | first1 = TH. | last2 = Evans | first2 = A. | last3 = Lockwood | first3 = G. | last4 = Tkachuk | first4 = D. | last5 = Bostwick | first5 = DG. | last6 = Epstein | first6 = JI. | last7 = Humphrey | first7 = PA. | last8 = Montironi | first8 = R. | last9 = Van Leenders | first9 = GJ. | title = Variability in diagnostic opinion among pathologists for single small atypical foci in prostate biopsies. | journal = Am J Surg Pathol | volume = 34 | issue = 2 | pages = 169-77 | month = Feb | year = 2010 | doi = 10.1097/PAS.0b013e3181c7997b | PMID = 20061936 }}</ref> | *There is no agreed upon minimum number of glands; however, one paper suggests that agreement among experts is low with 5 or less glands.<ref name=pmid20061936>{{Cite journal | last1 = Van der Kwast | first1 = TH. | last2 = Evans | first2 = A. | last3 = Lockwood | first3 = G. | last4 = Tkachuk | first4 = D. | last5 = Bostwick | first5 = DG. | last6 = Epstein | first6 = JI. | last7 = Humphrey | first7 = PA. | last8 = Montironi | first8 = R. | last9 = Van Leenders | first9 = GJ. | title = Variability in diagnostic opinion among pathologists for single small atypical foci in prostate biopsies. | journal = Am J Surg Pathol | volume = 34 | issue = 2 | pages = 169-77 | month = Feb | year = 2010 | doi = 10.1097/PAS.0b013e3181c7997b | PMID = 20061936 }}</ref> | ||
**Thus, it has been suggested that six or more glands should be present to diagnose cancer.<ref name=pmid20061936/> | **Thus, it has been suggested that six or more glands should be present to diagnose cancer.<ref name=pmid20061936/> | ||
Pathognomonic features of prostate carcinoma:<ref>{{Cite journal | last1 = Egevad | first1 = L. | last2 = Allsbrook | first2 = WC. | last3 = Epstein | first3 = JI. | title = Current practice of diagnosis and reporting of prostate cancer on needle biopsy among genitourinary pathologists. | journal = Hum Pathol | volume = 37 | issue = 3 | pages = 292-7 | month = Mar | year = 2006 | doi = | PMID = 16613324 }}</ref> | |||
#Perineural invasion. | |||
#*Must be circumferential (>95% of circumference{{fact}}). | |||
#Glomeruloid bodies. | |||
#Collagenous micronodules. | |||
<gallery> | <gallery> | ||
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</gallery> | </gallery> | ||
===Low power features=== | ===Divided into high and low power=== | ||
====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). | ||
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**"Infiltrative": small round/oval (malignant) glands (approx. 5 cells across) interspersed with larger (benign) glands that are 2-3 times larger. | **"Infiltrative": small round/oval (malignant) glands (approx. 5 cells across) interspersed with larger (benign) glands that are 2-3 times larger. | ||
===High power features=== | ====High power features==== | ||
*Nuclei. | *Nuclei. | ||
**Hyperchromatic nuclei (like in HGPIN). | **Hyperchromatic nuclei (like in HGPIN). | ||
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**May be difficult to see - especially if light intensity is low. | **May be difficult to see - especially if light intensity is low. | ||
***One should not use 400x to look for nucleoli (it is a waste of time + you risk over-calling something benign). | ***One should not use 400x to look for nucleoli (it is a waste of time + you risk over-calling something benign). | ||
*Loss of basal cells - diagnostic feature. | *Loss of basal cells - diagnostic feature. | ||
**Like in [[breast pathology]] (where one looks for loss of myoepithelial cells) - this may be difficult to see. | **Like in [[breast pathology]] (where one looks for loss of myoepithelial cells) - this may be difficult to see. | ||
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**If you find them the lesion is probably high-grade. | **If you find them the lesion is probably high-grade. | ||
**Generally, it isn't worth looking for them. | **Generally, it isn't worth looking for them. | ||
*The nucleoli should be 3 micrometres in size.{{fact}} | |||
===Mimics=== | ===Mimics=== | ||