ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Contemporary carly prostate cancer detection efforts frequently identify cancer at low clinical and pathologic stage, often resulting in small volumesm of tumor in radical prostatectomy speciments, The authors reported case in which adenocarcinoma could not be indentified in a radical prostatectomy specimen removed for biopsy-proven adenocarcinoma despite extensive effort. Genetic analysis confirmed that the biopsy specimen containing cancer and prostatectomy speciment were from the same patient, climinating the possibility of laboratory errors as the cause of not identifying cancer in the radical prostatectomy specimen. This experience is referred to as the “Vanishing cancer phenomenon.” Occasionally, cancer may be extremely difficult or impossible to find in the prostatectomy specimen despite exhaustive sampling. The incidence of this vanishing cancer phenomenon is probably increasing because more low stage cancers are being treated by prostatectomy. No method exists for predicting preoperatively which patients have small volumes of adenocarcinoma in the prostate. The inability to indentigy cancer in a prostate removed for biopsy-proven carcinoma may not be attributable to pathologise error.

ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A 61− year-old man in good health was found to have an elevated serum prostate-specific antigen level (8.9 mg/mL) on routine physical examination. Results of a digital rectal examination and transrectal ultrasound of the prostate were normal. Sextant needle biopsy specimens of the prostate were obtained, and the changes in one core from the right side were interpreted as moderately differentiated adenocarcinoma (Gleason grade 3 + 3 = 6). He underwent radical retropublic prostatectomy and bilateral pelvic lymphadenectomy; no cancer was indentified in the surgical specimen despite carful examination, Reevaluation of the diagnostic needle biopsy specimen revealed an irregular lobular cluster of small acini, which was reinterpreted as postatrophic hyperplasia (PAH), a histophathologic mimic of cancer. The small acini were lined by cuboidal coithelial cells with basophilic cytoplasm, slightly enlarged nuclei, and microunclcli, Basal cells were present but inconspicuous, Immunostaining with antibodies directed against high molecular weight cytokeratins demonstrated an intact but discontinuous basal cell layer. Postatrophic hyperplasia can be distinguished from adenocarcinoma by its charactenstic architecture, the presence of a basal cell layer, inconspicuous nucleoli, and the presence of adjacent acinar atrophy, Distinguishing PAH from carcinorna on needle biopsy speciment is especially difficult when only a portion of the lesion is sampled. Familiarily with this lesion should prevent misinterpretation as adenocarcinoma.

ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Prostate fine-needle aspiration biopsy (FNA) is an office procedure that is easily performed and readily accepted by most patients. With well-fixed cellular specimens, the pathologist can diagnose and grade prostate cancer confidently. The case presented in the current study serves as a spring board for discussion of the collection, processing adn diagnosis of prostate FNA.

ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The authors presented and unusual mixed carcinoid-adebicarcubina of the prostate with in situ and invasive components. The carcinoid tumor showed various architectural patterns including prominent multifocal spindle cell differentiation. Spindle cell carcinoid turnor is a recognized variant in other sites, but has not, to the best of the authors knowledge, been described in the prostate. The tumor expressed markers of neuroendocrne differentiation (chromogranin, neuron-specific enolase) as well as prostate-specific antigen adn prostatie acid phosphatase. In addition, there was an in situ component with histologic and immunohistochemical features of neuroendocrine differntiation. Although neuroendocrine differentiation has been documented in prostatic intraepithelial neoplasia, there have been no reports fo in situ neuroendocrine carcinoma. This unusual tumor expands the known spectrum of neuroendocrine differentiation in prostatic neoplasia.

ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Vasculitis is uncommon in the prostate and usually reflects systemic disease, such as Wegener's granulomatosis or polyatteritis nodosa. Isolated vasculitis without systemic involvement is exceedingly rate. The author reports two case of isolate polyarteritis nodosa—like vasculitis confined to the prostate. The vasculitis was identified incidentally in transurethral resection specimens for benigh hyperplasia from two men age 69 and 71 years. Neither patient received further treatment, adn there was no evidence of systemic vasculitis after a 36 and 42 month follow-up, respectively. These findings indicate that prostatic vasculitis is not always a manfestation of systemic disease, but rather, may occur as an isolated incident. It is important to distinguish case of isolated polyarteritis nodosa-like vasculitis in the prostate from systermic disease, because the latter implies a poor prognosis and is an indication for agressive rhcraphy.

ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Androgen deprivation theraphy of the prostate induces a distinctive histologic pattern chracterized by cytoplasmic clearing, nuclear and nucleolar shrinkage, chromatin condernsation, and single-file infiltration resembling lobular carcinoma of the breast. Recognition of this variant may be difficult in needle biopsies and lymph node metastases because of its subtle infiltrative pattern and inconspieuous nucleoli. The authors evaluated the morphologic changes in prostatic adenocarcinoma after androgen deprivation therapy in a case—control study. Redical retropublic prostatectomies from 16 treated patients (flutamide and/or gonadotropin-releasing-hormone agonist) and 16 untreated control patients were matched for clinical state (all “I” 3) and posttreatment Gleason grade. Treated patients showed a significantly lower nuclear grade (grade on a 1—4 scale; P < 0.001) and smaller nucleolar diameter (morphometric analysis of 150 nucleoli from each case; P < 0.001) when compated with untreated control patients. There was no significant difference between the groups in frequency of aneuploidy or immunohistochemical expression of prostate specific antigen, prostatic acid phosphatase, S–10 protein, chromogranin, neuron-specific enolase, scrotonin, or basal cell–specific keratin.

ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Nuclear DNA content analysis in radical prostatectomy specimens provides useful information for assessing clinical behavior of prostate cancer, but its use in needle biopsies and small samples is uncertain. Preliminary findings from this prospective study of DNA contents in high grade prostatic intraepithelial neoplasia and carcinoma form needle biopsies indicated that digital image analysis is very effective.

ISSN:1082-9784    

出版商:OVID    

年代:1996

数据来源: OVID