Diagnostic utility of core biopsy in histomorphologic evaluation of prostatic carcinoma

Abstract

Core biopsy is a minimal invasive procedure that can help in a definitive diagnosis. Clinicopathological correlation is necessary for early detection of prostate cancer.To correlate histomorphological features of prostatic lesions with clinical data by evaluating core biopsy.The present study was conducted in Department of Pathology in a tertiary care hospital. Fifty eight prostatic core biopsies which were clinically suspicious of malignancy with Digital Rectal Examination, Prostate Specific Antigen (PSA) levels and Transrectal ultrasound (TRUS) /magnetic resonance imaging (MRI) findings were considered.Eighty six percent of the suspected cases turned out to be malignant. Most of the patients were of age group 66-75 years. The most common chief complaint was lower urinary tract symptoms. On Digital Rectal Examination, 64% of cases presented with hard prostate and prostatomegaly. 86% of the cases had PSA level >10ng/ml. TRUS was performed in 45% of cases and MRI in remaining 55% of cases. The commonest Prognostic Grade Group was V, Modified Gleason score was 9, Gleason pattern was 4. Prostatic intraepithelial neoplasia was associated in 45% of the cases. 21% of the cases presented with extraprostatic metastasis(bone).Prostatic core biopsy along with clinical correlation stands out to be a good screening test in association with histomorphologic evaluation for the early diagnosis in clinically suspicious cases of prostatic carcinoma.