Study of Various Histopathological Patterns in Turp Specimens and Incidental Detection of Carcinoma Prostate

Abstract

Background (Aims and Objective): Study of various histopathological patterns in TURP specimens diagnosed as Benign Prostatic Hyperplasia, identifying type and grade of inflammation, incidental detection of carcinoma prostate and application of modified Gleason system. Materials and Methods: From January 2014 to August 2015 a total of 50 TURP specimens were evaluated. The tissue blocks and H&E stained slides of the tissues were retrieved and slides reviewed. Various patterns of proliferation, types and grade of inflammation were studied and classified using standard methods. Incidentally identified carcinoma prostate were classified using WHO Classification and graded using modified Gleason system. Results: 48(96%) were BPH with co-existing chronic prostatitis 12(24%) granulomatous prostatitis 1(2%) and acute prostatitis 2(8%). Papillary hyperplasia was predominant finding 17(34%). Less frequent finding was basal cell hyperplasia, 6(12%) atypical adenomatous hyperplasia 4(8%) and cribriform hyperplasia 1 (2%). Proliferative inflammatory atrophy constituted 3 cases(6%).Scattered necrotic glands were present in 20(40%) cases, periglandular lymphoid aggregation was a frequent finding in these necrotic glands. we reported two cases of adenocarcinoma prostate with modified Gleason score of one (5+4=9) and another score of (5+3=8). Conclusion: With increase in the incidence and mortality rates from prostate cancer, every effort should be made to improve diagnosis. It is necessary to review periodically all TURP in order to identify premalignant lesions, proliferative activity, and grade of inflammation. Efforts should be made to apply modified Gleason system to improve management facility. We also conclude that proliferative activity and invasiveness increases from benign to the malignant end in the spectrum of prostatic lesion. Keywords: Benign Prostatic Hyperplasia, Prostate Carcinoma, Aah, Pia, Chronic Prostatitis.