Abstract
: Prostatic carcinoma is the second most common cause of cancer deaths in men and the incidence is increasing significantly in recent years, due to early screening measures. A study designed to identify the prostatic lesions spectrum as per histopathological classification.: 50 prostatic lesion samples collected in 10% formalin were subjected to H and E stain and the mean AgNOR counts were calculated.: Out of 50 specimens, 80% were benign and 20% belongs to malignancy. The mean age of patient’s benign and malignant lesions is 63.5 ± 9.2 years and 69.5 ± 8.5 years respectively (P=0.09). The most common clinical symptom of benign lesions was frequency in35 patients, followed by hesitancy and nocturia in 33 and 30 patients respectively. Serum PSA values above 10ng/ml were seen in 10 benign cases and 5 malignant cases (P=0.02). Out of 50 cases, 35 were BPH, 5 were non-specific granulomatous prostatitis, 8 prostatic adenocarcinoma, 1 case urothelial carcinoma and 1case with both prostatic adenocarcinoma and urothelial carcinoma were recorded. High grade PIN identified in 9 specimens and low grade PIN identified in 8 specimens. High grade PIN shows association with adenocarcinoma. Basal cell hyperplasia identified in 3 specimens. Tufting Pattern was observed in 2 specimens, flat Pattern observed in 4 specimens, and cribriform pattern observed in 1 specimen out of 9. Majority of patients diagnosed as conventional adenocarcinoma with a score of 9 (3 cases) followed by score of 8 (2 cases).: BHP is the most common non neoplastic prostate lesion, and commonly encountered in age group of 60- 70 years. In the current scenario, histopathological analysis of prostate specimens plays crucial role in both diagnosis and management.
Highlights
Patients presenting with prostatic symptoms account for 22% of the total urology cases, and every 7th patient will be presenting with urologic emergency. 1Prostatic carcinoma, the leading cause of cancer in western population after lung cancer which is leading cause of deaths in men. 2 Almost 75% of the men diagnosed with prostatic carcinoma are aged 65 or older, but the tumours can be seen even in children and adolescents though, very rarely. 3,4Prostatitis, benign nodular hyperplasia, and prostatic adenocarcinoma are the common diseases affecting men commonly after their fifth decade. 5The diagnosis of prostatic carcinoma is usually too late because there are no signs and symptoms specific to malignancy other than those for BPH
Advances in the field of biochemistry that have brought out PSA and other markers are valuable diagnostic tools, advances in the field of radiodiagnosis that have provided Transrectal ultrasound, advances in the field of instrumentation and biopsy procedure, TURP and prostatectomy that have led to the minimally invasive procedures like Needle biopsy, ongoing research in prostate pathology that led to the documentation of premalignant lesions like PIN & AAH
Out of 50 prostatic specimens received, 40 cases were benign lesions and prostatic malignancy was diagnosed in 10 cases
Summary
Prostatitis, benign nodular hyperplasia, and prostatic adenocarcinoma are the common diseases affecting men commonly after their fifth decade. 5. The diagnosis of prostatic carcinoma is usually too late because there are no signs and symptoms specific to malignancy other than those for BPH. Prostatic carcinoma is the second most common cause of cancer deaths in men and the incidence is increasing significantly in recent years, due to early screening measures. The mean age of patient’s benign and malignant lesions is 63.5 ± 9.2 years and 69.5 ± 8.5 years respectively (P=0.09). The most common clinical symptom of benign lesions was frequency in patients, followed by hesitancy and nocturia in 33 and 30 patients respectively. Conclusion: BHP is the most common non neoplastic prostate lesion, and commonly encountered in age group of [60- 70] years. Histopathological analysis of prostate specimens plays crucial role in both diagnosis and management
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