Clinicopathological study of associated lesions in benign prostatic hyperplasia and prostatic adenocarcinoma in surgical biopsy specimens
Keywords:
Prostatic carcinoma, benign prostatic hyperplasia, adenocarcinoma, basal cell hyperplasia, atypical adenomatous hyperplasia
Abstract
Background: Benign prostatic hyperplasia (BPH) and prostatic adenocarcinoma are two principal conditions of prostate among elderly men. In spite of significant advances in early detection of prostatic carcinoma by transrectal ultrasound and serum prostatic specific antigen, major diagnostic problem exists in the diagnosis between adenocarcinoma and benign small acinar proliferations. This study aims to study the association of hyperplastic, metaplastic, inflammatory and premalignant lesions in prostate specimens over a period of 5 years and to analyze histological types and significance of associated lesions in BPH and different grades of prostatic adenocarcinoma.Methods: Prostate specimens over a period of 5 years were analyzed for gross and microscopic findings. All prostatic adenocarcinoma cases are graded using Gleason grading system and analyzed for the presence of prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH) and other associated lesions.Results: BPH constitute the commonest lesion (92.1%), followed by Adenocarcinoma (7.9%). All cases of focal acinar/cystic atrophy showed increase in trend towards increasing age. Among hyperplastic lesions, basal cell hyperplasia was found to be the most common epithelial lesion. Among premalignant lesions, PIN was found most commonly in association with prostatic adenocarcinoma. In concurrence with literature it was observed that high-grade PIN was the most common premalignant lesion associated with prostatic adenocarcinoma (51.2%) than AAH.Conclusion: LGPIN, HGPIN and chronic prostatitis were found to be associated with adenocarcinomas (statistically significant with P<0.05), when they are compared with benign prostatic hyperplasia and not statistically significant (P>0.05) when comparison is done between low- and high-grade adenocarcinoma.DOI:10.21276/APALM.1608References
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13. Atchyuta Mathi, R. Krishna, S. Indira Devi. Histological Spectrum of Non-Malignant Lesions of Prostate. International Journal of Science and Research 2015;4(10):192-196.
14. Ashish Joshee, Kaushal CL Sharma. The histomorphological study of prostate lesions. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2015;14(11 ver VIII):85-89.
15. Josephine A. Clinicopathological study of prostate biopsies. Journal of Clinical and Diagnostic Research 2014;8(9):FC04-FC06.
16. Shirish C, Jadhav PS, Anwekar SC, Kumar H, Buch AC, Chaudhari US. Clinico-pathological study of benign & malignant lesions of prostate. International Journal of Pharmacy and Biological Sciences 2013;3(1):162-178.
17. Wasim Khatib, Sunil Jagtap, Rakesh Demde, Dhirajkumar Buddhiram Shukla, Tasneem Bisht. Clinicopathological study of prostate lesions - A one year study. International Journal of Medical Research & Health Sciences 2016;5(5):183-186.
18. Clement Wilfred D, Rashmi Krishnappa, Sharath Soman, Vijaya Viswanath Mysorekar, Radhika Kunnavil, Sharon Roshin Reginalt. Clinicopathological Evaluation of Prostatic Adenocarcinoma: A Unicenter Study. Annals of Pathology and Laboratory Medicine 2016;3(5):A421-A426.
19. Shohreh Iravani Dickinson. Premalignant and Malignant Prostate Lesions: Pathologic Review. Cancer Control 2010;17(4): 214-222.
2. Amin MB, Tamboli P, Varma M, Srigley JR. Post atrophic hyperplasia of the prostate gland: a detailed analysis of its morphology in needle biopsy specimens. Am J Surg Pathol 1999;23(8):925-31.
3. Young RH. Pseudoneoplastic lesions of the prostate gland. Pathol Annu 1988;23Pt 1:105-28.
4. Yantiss RK, Young RH. Transitional cell metaplasia in the prostate gland. J Urol Pathol 1997;7:71-80.
5. Franks LM, O'shea JD, Thomson AER. Mucin in the prostate: a histochemical study in the normal glands, latent, clinical and colloid cancers. Cancer 1964;17:983-91.
6. Grignon DJ, O'Malley FP. Mucinous metaplasia in the prostate gland. Am J Surg Pathol 1993;17(3):287-90.
7. McNeal JE, Bostwick DG. Intraductal dysplasia: A premalignant lesion of the prostate. Hum Pathol 1986;17(1):64-71.
8. Troncoso P, Babaian RJ, Ro JY, et al. Prostatic intraepithelial neoplasia and invasive prostatic adenocarcinoma in cystoprostatectomy specimens. J Urol 1989;34(Suppl):52-56.
9. Junqi Qian, Peter Wollan, David G Bostwick. The extent and multicentricity of high-grade prostatic intraepithelial neoplasia in clinically localized prostatic adenocarcinoma. Hum Pathol 1997;28(2):143-148.
10. Montironi R, Thompson D, Bartels PH. Premalignant lesions of the prostate. In: David G Lowe & James CE Underwood. Recent advances in histopathology (18). Churchill Livingstone Publications, 1999;8:147-172.
11. Mai KT, Isotalo PA, Green J, Perkins DG, Morash C, Collins JP. Incidental prostatic adenocarcinomas and putative premalignant lesions in TURP specimens collected before and after the introduction of prostrate-specific antigen screening. Arch Pathol Lab Med 2000;124(10):1454-6.
12. Patel SK, Surti HB. Analysis of prostatic biopsies in a tertiary care hospital in correlation with prostate-specific antigen levels: A clinicopathological study. Int J Med Sci Public Health 2017;6 (Online First). Doi: 10.5455/ijmsph.2017.1060318112016
13. Atchyuta Mathi, R. Krishna, S. Indira Devi. Histological Spectrum of Non-Malignant Lesions of Prostate. International Journal of Science and Research 2015;4(10):192-196.
14. Ashish Joshee, Kaushal CL Sharma. The histomorphological study of prostate lesions. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2015;14(11 ver VIII):85-89.
15. Josephine A. Clinicopathological study of prostate biopsies. Journal of Clinical and Diagnostic Research 2014;8(9):FC04-FC06.
16. Shirish C, Jadhav PS, Anwekar SC, Kumar H, Buch AC, Chaudhari US. Clinico-pathological study of benign & malignant lesions of prostate. International Journal of Pharmacy and Biological Sciences 2013;3(1):162-178.
17. Wasim Khatib, Sunil Jagtap, Rakesh Demde, Dhirajkumar Buddhiram Shukla, Tasneem Bisht. Clinicopathological study of prostate lesions - A one year study. International Journal of Medical Research & Health Sciences 2016;5(5):183-186.
18. Clement Wilfred D, Rashmi Krishnappa, Sharath Soman, Vijaya Viswanath Mysorekar, Radhika Kunnavil, Sharon Roshin Reginalt. Clinicopathological Evaluation of Prostatic Adenocarcinoma: A Unicenter Study. Annals of Pathology and Laboratory Medicine 2016;3(5):A421-A426.
19. Shohreh Iravani Dickinson. Premalignant and Malignant Prostate Lesions: Pathologic Review. Cancer Control 2010;17(4): 214-222.
Published
2018-02-27
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