Clinicopathological study of associated lesions in benign prostatic hyperplasia and prostatic adenocarcinoma in surgical biopsy specimens

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 comparison is done between low- and high-grade adenocarcinoma. DOI:10.21276/APALM.1608