TURP Specimens Research Articles

Incedental Cancer of Prostate Among Patienst Undergoimg Transurethral Resection of Prostate aged more than 50 Years

Objective: To determine the incidental cancer of prostate among patienst undergoimg transurethral resection of prostate aged more than 60 years at tertiary care Hospital Subjects and Methods: This cross-sectional asutyd was done at pathology daerpatemnt of LUMHS from January 2019 to December 2020. Satudy was done after atking ethical approval fron ethical review commetee of LUMHS Jamshoro. TURP specimens underwent overnight processing after being fixed ino 10% neutral buffered formalin. Each block had a single section taken from it that was stained with hematoxylin and eosin and inspected histologically. On the glass slides, all foci were marked, and the tumour volume was calculated as a visual representation of the tumor's percentage of the specimen's total surface area. According on the 2005 International Association of Urological Pathol (ISUP) consensus recommendations, Gleason scoring was performed. With immunoperoxidase staining, small tumour foci were confirmed. pT1a disease was defined as incidental tumor in 5% of TURP specimens. pT1b disease was defined as incidental tumor in > 5% of TURP specimens. All the data was collected via suyd profoema. SPSS version 26 was used for the data analysis. Results: A toat of 800 cases were studied the incidence of prostate carcinoma was estimated 39.25%. mean age of the patients was 66.95+9.37 years. Most of the cases had, tumor grade II to V as 18.3%, 18.3%, 17.0% and 36.9% respectively. As per estimated tumor invasion, most of the cases had tumor invasion was >25% as 22.8% ahd tumor invesion 26-50%, 27.6% and 51-75% and 30.1% had 76-100%. Perineural invasion was observed in 42.3%of the cases and lymphovascular invasion was only in 3.2% of the acses. Conclusion: The incidence of prostate carcinoma was observed to the highly frrequenct as estimated 39.25% and most of the cases had, tumor grade II to V. Keywords: Prostate, incidental cancer, stages

Every TURP Is not Just BPH

Abstract Introduction/Objective Transurethral resection of prostate is a common specimen in surgical pathology practice. These specimens usually demonstrate benign prostatic hyperplasia. However, occasionally incidental prostate cancer is identified. Finding a true mesenchymal tumor in these specimens is exceedingly rare. We present a unique case of prostatic adenocarcinoma Gleason score 3 + 4 =7 and concurrent solitary fibrous tumor identified on a TURP specimen. Solitary fibrous tumor in this anatomical location is rare with approximately 50 cases reported in the English language literature. Methods/Case Report An 86-year-old male presented with symptoms and signs of urinary retention. On clinical evaluation the prostatae was profoundly enlarged with a calculated volume of 283cc; firm in consistency. He was given trial of medical management including finasteride, tamsulosin and Foley catheter placement. Subsequently, the patient underwent transurethral resection of prostate. Complete morcellation was not possible at the initial surgery due to hard consistency of the gland. Pathologic evaluation showed prostatic adenocarcinoma Gleason grade 3 + 4=Score 7 (Grade group 2) involving 10% of submitted tissue in addition to the changes of benign prostatic hyperplasia. Additionally, the background stroma demonstrated short plump oval to spindle cells with inconspicuous nucleoli and collagenous background, arranged in a haphazard (‘‘patternless’’) pattern. Immunohistochemical stains showed these lesional cells to be positive for STAT6 and CD34 and negative for desmin, S100, SOX-10, CD 117, DOG-1 and NKX 3.1. Morphology and immunohistochemical profile were compatible with solitary fibrous tumor involving the prostate. The patient is alive and symptom-free 9 months after the procedure. Results (if a Case Study enter NA) NA. Conclusion This case highlights the value of thorough evaluation of prostatic tissue in TURP specimens not only for prostate cancer but other tumors as well. It also reminds the practising pathologist to keep an eye out for the stromal lesions of the prostate gland. Also finding one lesion should not dissuade one from looking for additional concurrent lesions.

Incidence of prostatic intraepithelial neoplasia in TURP specimens with special reference to p63 expression in various lesions of prostate

Introduction: Prostate cancer is the second common malignancy in men. Prostatic intraepithelial neoplasia (PIN) is the precursor lesion of prostatic carcinoma. Histopathological examination is necessary to diagnose PIN lesions. Objective: The aim of the study is to determine the incidence of Prostatic intraepithelial neoplasia and to analyse the usefulness of basal cell marker p63 expression in various lesions of prostate. Methods: This is a two-year prospective study of 65 transurethral resection specimens of prostate, carried out in the Department of pathology, Dr B R Ambedkar Medical College, Bangalore. mmunohistochemical marker p63 is used and its expression in various lesions was analysed. Results: Out of 65 cases studied, 4 were inflammatory lesions, 52 were benign prostatic hyperplasia (BPH) and 9 were malignant lesions. Low grade PIN was identified in 8(12.3%) cases of BPH. High grade PIN was seen in 9(13.8%) cases and tufting pattern was the commonest. HGPIN was predominantly associated with adenocarcinoma. p63 was expressed in all the benign glands in BPH and HGPIN. Malignant glands were negative for p63 expression.

COMPARISON OF BASAL-CELL SPECIFIC MARKERS – P63 AND 34BETAE12 IN PROSTATIC GLANDULAR PROLIFERATIONS

Background: The prostate is a retroperitoneal organ encircling the neck of the bladder and urethra. Though the diagnosis of the prostatic lesions are analyzed through histopathological examination (HPE), sometimes, diagnosis can be challenging, when pathologist are faced with certain problems such as small foci of Ca or benign mimickers. In such situation, immunohistochemical (IHC) detection of basal cells are widely used. To Objectives: assess the expression of basal cell markers (p63 and 34betaE12) in various prostatic glandular proliferations and to differentiate suspicious glandular lesions as benign or malignant. A two year cross-sectional s Methods: tudy (Sept'2016 –Aug'2018) , total of 52 cases of both TURP and prostate biopsy specimens sent to the department of Pathology, RIMS for HPE were studied using IHC markers p63 and 34betaE12, following H&E stain and the expressions of the markers were studied. Results: Out of 52 cases, 41(78.8%) cases were diagnosed as Benign proliferative hyperplasia (BPH), 8(15.4%) cases as prostatic carcinoma, 2(3.8%) cases as high grade prostatic intraepithelial neoplasia (HGPIN) and one (1.9%) case of adenoleiomyobromatous hyperplasia (AMFH) on H&E section with age range of 51 to 90 years (mean age: 72 years). Following IHC staining, 43 (97.7%) benign cases were positive for both p63 and 34betaE12, one (2.3%) case of benign lesion was negative for both the IHCs. 8(100%) cases of malignant lesions were negative for both the IHCs. A p-value of 1.000 was observed indicating that there is no signicant difference in the sensitivity of p63 and 34betaE12. In this cross- Conclusion: sectional study of 52 cases of prostatic lesions, HPE and the role of basal cell specic IHC markers p63 and 34beta12 were studied. No signicant difference was observed in the sensitivity between the two markers. Further comparative study with larger sample size is needed to comprehend the differences in the utility of p63 and 34etaE12 in diagnosing suspicious prostatic lesions.

Study of Expression of P53 in Prostatic Lesions

Prostate gland is an accessory gland of the male reproductive system.Prostate begins development from the mesenchymal tissue, surrounding the urogenital sinus in the 3 rd month of gestation. Epithelial buds invaginate from the posterior sinus on either side of verumontanum. Concurrently, Wolffian ducts develop into seminal vesicles, epididymis, Vasdeferens and ejaculatory ducts that are stimulated by fetal testosterone. Histologically all malignant lesions encountered were Conventional Adenocarcinoma of Prostate. The commonest pattern seen was acinar followed bycribriform and fused glandularpattern. Conventional Adenocarcinoma forms the most commontype of prostatic carcinoma and they are moderately differentiated byGleason’s microscopicgrading. Serum Prostate Specific Antigen (PSA) levels increases proportionately with advancing clinical stage. Studies have shownthat serial increase in serum PSA is associated with incidence of occult carcinoma.In the present study, the TURP specimen received was ranged in the volume from 8 to 20cc. Every tissue was carefully examined for the presence of yellow and firm or gray hard areas and necrotic areas. After fixation and processing, 4 -5µ sections were cut and Hematoxylin and Eosin staining was done. In the present study all the benign lesions stained negative except for cases were the PSA value is more than >50ng/ml with p53 IHC and in prostate carcinoma positive indicating epithelial marker positive for prostate gland. In coclusio, the IHC expression of p53 is significantly up- regulated in malignant lesions and have importance in prognostic factors and disease survival.

Utility of p63 and AMACR in Differentiating Benign and Malignant Prostatic Lesions

Background: Prostate cancer is the sixth most common cancer in the world. Since treatment options and prognosis of prostatic adenocarcinomas and benign lesions differ significantly, so, the current study using p63and AMACR was carried out with aim to evaluate the utility of immunohistochemistry in resolving ambiguous lesions of prostate.
 Methods: The study was conducted on 130 prostatic specimens which included prostate biopsy, TURP and prostatectomy specimens. Routine hematoxylin and eosin staining and immunohistochemical staining using AMACR, p63 monoclonal antibody marker were performed.
 Results: Total of 130 cases of prostate samples were studied out of which benign lesions were seen in 102 cases (78.5%) and malignant carcinoma in 28 cases (21.5%). This study showed p63 had a sensitivity of 92.86% and specificity of 100% whereas AMACR has a sensitivity of 96.4% and specificity of 95%. BPH with prostatitis was a common finding in majority of benign lesions. All cases of LGPIN 15 cases (11.5%) were histologically associated with BPH, showing complete positivity in 12 cases (80%) and partial positivity in 3 cases (20%) with p63 immunostaining. HGPIN (1.5%) were associated with prostatic adenocarcinoma showing focal positivity whereas adenocarcinoma showed complete negativity of p63 expression (100%) and positive cytoplasmic staining with AMACR. Comparative study done between DRE, PSA, final histopathological diagnosis, expression of p63 and AMACR immunostaining gives highly significant p value of 0.001(<0.05).
 Conclusion: p63 and AMACR are reliable markers which can be used in morphologically difficult cases.

S1621 Bladder in the Colon: A Rare Case of Hematochezia

INTRODUCTION: Colorectal cancer is the most common malignancy in the GI tract. Metastatic lesion to the colon are uncommon, accounting for only 1% of all colorectal neoplasms. The most common form of metastatic spread to the bowel is through peritoneal spreading. Hematogenous and lymphatic spread to the colon is reported in breast carcinoma, lung carcinoma, and melanoma. We present a rare cause of colorectal neoplasm. CASE DESCRIPTION/METHODS: A 65yo male with a history of ESRD and urothelial carcinoma presenting with hematochezia for 2 day. Symptoms began abruptly and were painless. He reported dizziness. He denied prior history of similar episodes. Patient denied melena, constipation, or any other GI symptoms. He is not on blood thinners. Of note, patient has chronic hematuria related to his malignancy, requiring blood transfusions. His most recent outpatient labs 1 week prior revealed a hemoglobin of 8.6g/dL. Patient is on neoadjuvant pembrolizumab. Surgical history included a prior bladder biopsy. He had no reported of prior colonoscopy. He is a former smoker with no other toxic habits and no pertinent family history. On admission, HR 110, BP 85/50, and was afebrile, saturating 100% on room air. Exam was remarkable for conjunctival pallor. Rectal exam revealed red blood without notable masses or lesions. Labs were significant for a hemoglobin of 7.1g/dL, creatinine of 3.5 and BUN of 42. The remainder of his CBC and CMP were unremarkable. He was transfused 1unit packed red blood cells and given IV fluids with improvement in his BP. He underwent a colonoscopy which revealed a 4 × 3 cm cecal mass with an adherent clot. The mass was injected with epinephrine, clot was successfully removed, and the mass was biopsied. Additionally, there was blood throughout the colon, and non-bleeding diverticuli in the transverse and sigmoid colon. Pathology revealed high grade carcinoma consistent with metastatic urothelial carcinoma, morphologically similar to his prior TURP specimens. Patient had a follow-up CT C/A/P that showed no other notable metastatic disease with stable bladder mass noted on a surveillance CT scan 3 months prior. Patient went for a right hemicolectomy for further management. Patient had oncologic followup for treatment. DISCUSSION: Although colon malignancy is common, metastatic urothelial cancer isolated in the colon is rare. Managing such cases is difficult as literature is unavailable. Further research is needed to understand methods of metastasis, predicting outcomes, and managing patients.Figure 1.: Cecal mass with notable adherent clot.Figure 2.: Cecal mass status post epinephrine injection and clot removal.

To determine the frequency of prostate malignancy in patients with clinically benign prostate

To see the frequency of prostatic malignancy in patients presenting with clinically benign prostate. Study Design: Descriptive case series. Setting: Department of Urology at Peoples University of Medical and Health Sciences for Women / Hospital Nawabshah. Period: Fifteen Months, From October 2016 to December 2017. Materials and Methods: A total of 100 patients who presented with the clinically benign prostate in Urology OPD were enrolled. All concern data regarding Age, mode of presentation (lower urinary tract symptoms with IPSS score/ Acute retention of urine), comorbid, clinical examination findings, pre voided and post-void residual urine determination (on ultrasonography) were entered. The laboratory investigation includes complete blood count, urea, creatinine, random blood sugar (RBS), urine DR and CS, coagulation profile were performed before TURP.TURP performed under spinal anesthesia. After TURP the prostatic tissue chips were sent for histopathology as a routine. Data was analyzed through SPSS Version 20.0. Results: The average age of males was 71.38± 7.19 yrs. Most of the patients with (IPSS 20-35) BPH have lower urinary tract symptoms (both obstructive and irritative). DRE was done in all patients to estimate the size of the prostrate, it was varying from grade 1 enlarged n= 27(27%), grade 2 enlarged n= 36(36%), to grade 3 enlarged in n=37(37%). There were 3 (3%) cases reported to have prostate cancer, with findings confirmed by biopsy of TURP Specimen. There was no mortality seen in our study. The clinical presentation of patients, grades of enlargements on DRE and IPSS however, demonstrated no correlation. Conclusion: BPH is more common between 60-80yrs. When patient undergo TURP or open prostatectomy, every specimen should be sent for biopsy because prostate cancer is only confirmed by biopsy, so that prostate cancer is detected early Radiology & PSA values are supportive in their role but are not true diagnostic. Prostatic cancer is a significant morbid condition, so effective measures should be taken to detect prostatic cancer, so that patient can be properly treated according to the stage.

Prostatic lesions: A retrospective study of Turp Specimen

Introduction: The term “prostate” is originally derived from the Greek word “prohistani”, meaning “to stand in front of” [1]. The term “prostate” is originally derived from the Greek word “prohistani”, meaning “to stand in front of” [1]. It is one of the most commonly affected organs in elderly males,so early detection and management is required. Methods: The study includes 215 cases of TURP specimen for 2 years period from January 2017 to December 2018 received in department of pathology, D. Y. Patil Institute of Medical sciences and Hospital, Kolhapur. Hematoxylin and Eosin sections were examined. The clinical complaints and microscopic details were analysed and compared with similar studies. Malignancy was reported according to Gleasons score. Results: Of the total 215 TURP specimen, 179 (83.25%) were of nodular hyperplasia, 19 (8.8%) were of nodular hyperplasia with prostatitis, 3 (1.4%) were of prostatic intraepithelial neoplasia and 9 (4.18%) cases were malignant. Few cases were of granulomatous prostatitis in (2) and atypical adenomatous hyperplasia (1). All the 11 cases of prostate cancer were incidental carcinoma, 1 of which was poorly differentiated, 1 case was of well differentiated adenocarcinoma and 9 cases were of moderately differentiated adenocarcinoma. Conclusion: The present study showed that out of 215 cases of TURP, the most frequently encountered prostatic lesion were benign, out of which majority were BPH 83.25% commonly seen in the age group of 61-70 years. The malignant lesions were common more than 65 years of age. TURP is helpful in early identification of premalignant lesions and incidental prostate cancer.

Corpora amylacea in prostatectomy tissue and associations with molecular, histological, and lifestyle factors.

Corpora amylacea are amyloid bodies commonly found adjacent to damaged prostate epithelium. Little is known about their formation or function. The current study sought to characterize corpora amylacea in prostate tissue and to describe their relationship with clinical, histological, molecular, and lifestyle factors, especially with chronic inflammation which is associated with aggressive disease. We studied a cohort of 355 men with prostate cancer and tissue specimens from the Health Professionals Follow-Up Study. Pathologists examined H&E slides and undertook a standardized review for histologic data and inflammation. Trained observers counted corpora amylacea within the benign and predominately tumor areas. Immunohistochemistry biomarkers were available from tissue microarrays. We used multivariable logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) to assess associations of chronic inflammation, clinical, histological, molecular, and lifestyle factors with the presence of corpora amylacea. Corpora amylacea were present in benign tissue area for 298 men (84%). Specimens with moderate-to-severe chronic inflammation were more likely to have corpora amylacea in benign regions (OR = 5.4 95%CI 1.9, 15.6). Moreover, corpora amylacea were more common in men with higher body mass index (OR = 1.13 95%CI 1.01, 1.26). In contrast, Gleason grade (OR = 0.4 95%CI 0.2, 0.8), proliferation index (OR = 0.6 95%CI 0.3, 1.2) and the presence of the TMPRSS2:ERG fusion (OR = 0.4 95%CI 0.2, 0.8) were inversely associated with corpora amylacea presence. TURP specimens were less likely to have corpora amylacea than prostatectomy specimens (OR = 0.12 95%CI 0.03, 0.47). Age, PSA, stage, biomarkers of angiogenesis and PTEN, and vasectomy were not significantly associated with corpora amylacea. Corpora amylacea were common among men with prostate cancer and were associated with pro-inflammatory factors, some markers of less aggressive disease, and lack of the TMPRSS2:ERG fusion.

Incidental Diagnosis of Carcinoma Prostate Of Turp Chips Done for Bph : A Study of Chittagong Medical College Hospital

Background: Prostate cancer awareness is increasing day by day, especially in the USA and western world. Before PSA period, up to 27% of prostate cancers were detected incidentally in the TURP chips done for BPH. The Incidental diagnosis of prostate cancer in patients treated for BPH by a transurethral prostate resection is seen in 1.4-16.7% of patients, but it’s incidence is decreasing due to the use of Serum PSA testing. Nevertheless, some patients are still diagnosed with incidental prostate cancer. However, incidentally detected carcinoma prostate has been reported to vary across the globe since various factors can influence the identification of this malignancy in TURP specimens. In this study, we concentrated on rates of incidentally detected prostate cancer in TURP chips done for BPH in our hospital. Materials and methods: This retrospective study of histopathological findings of TURP chips was conducted for patients undergoing TURP from 2010. The inclusion criteria were patients diagnosed with BPH, DRE showing no abnormal hard areas and age adjusted PSA value is normal. Patients with elevated PSA, abnormal DRE, documented urinary tract infection and proved Adenocarcinoma Prostate (CaP) were excluded from the study. The age of the patients, clinical diagnosis, occurrence of carcinoma of prostate in the TURP chips and Gleason’s scores were recorded. Results: A total of 263 patients who fulfilled the inclusion criteria were studied. The incidence of CaP in the study group was 5.3 % (14/263). 10 (71.4 %) patients were aged ³65 years or older had maximum incidence of CaP. Conclusions: The rate of incidentally detected adenocarcinoma prostate in patients undergoing TURP for clinically diagnosed BPH was found to be only 5.3 % in our study, which is low when compared with similar studies done elsewhere in the world.
 JCMCTA 2017 ; 28 (2) : 16-20

Establishment of primary patient-derived xenografts of palliative TURP specimens to study castrate-resistant prostate cancer.

Fresh patient specimens of castrate-resistant prostate cancer (CRPC) are invaluable for studying tumor heterogeneity and responses to current treatments. They can be used for primary patient-derived xenografts (PDXs) or serially transplantable PDXs, but only a small proportion of samples grow successfully. To improve the efficiency and quality of PDXs, we investigated the factors that determine the initial engraftment of patient tissues derived from TURP specimens. Fresh tissue was collected from castrate patients who required a TURP for urinary symptoms. Tissue was grafted under the renal capsule of immune-compromised mice for up to 14 weeks. The abundance of cancer in ungrafted and grafted specimens was compared using histopathology. Mice were castrated or implanted with testosterone pellets to determine the androgen-responsiveness of CRPC PDXs from TURP tissue. Primary PDXs were successfully established from 7 of 10 patients that underwent grafting. Of the 112 grafts generated from these 10 patients, 21% contained cancer at harvest. Grafts were most successful when the original patient specimens contained high amounts of viable cancer, defined as samples with (i) at least 50% cancer cells, (ii) no physical damage, and (iii) detectable Ki67 expression. PDX grafts survived in castrated hosts and proliferated in response to testosterone, confirming that they were castrate resistant but androgen-responsive. Primary PDXs of CRPC can be established from TURP specimens with modest success. The take rate can be increased if the original tissues contain sufficient numbers of actively proliferating cancer cells. Selecting specimens with abundant viable cancer will maximize the rate of engraftment and increase the efficiency of establishing PDXs that can be serially transplanted.

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

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.

Stage pT0 after radical prostatectomy: a diagnostic dilemma.

We assessed the misdiagnosed prostate cancer in radical prostatectomy (RP) specimens and the associated parameters. A total of 3,821 patients were treated by RP. A meticulous process to identify misdiagnosed PCa in the specimen was followed. This protocol included the review of biopsies, prostatic specimens after TURP and RP surgical specimens. The prostatic specimens were further sectioned. Immunohistochemistry was also performed. The clinical parameters of the cases that were confirmed to be pT0 stage were compared to 1,164 RP patients. The incidence of pT0 was 0.7 % of the cases. Eighteen patients (Group A) were operated after TURP and 10 patients (Groups B) after transrectal ultrasound-guided biopsy of the prostate. Eleven (Group Ac) cases of Group A and seven (Group Bc) cases of Group B were confirmed to be pT0 cases. The re-examination of the slides and specimens revealed the presence of PCa in three cases. The remaining cases were detected by IHC. The comparison of Group Ac to the Group C (representative cohort, 1164 patients) showed that the pre-operative PSA value was significantly higher in the case of the Group C. The pre-operative Gleason, the percentage of biopsy cores for cancer and the length of cores containing cancer were observed to be significantly lower in the case of Group Bc in comparison with Group C. The meticulous search protocol in pT0 cases showed that 35.7 % of the specimens included undiagnosed PCa. This strengthens the need for further careful work-up of any RP specimen of stage pT0.

Detection of infectious organisms in archival prostate cancer tissues.

BackgroundSeroepidemiological studies have reported associations between exposure to sexually transmitted organisms and prostate cancer risk. This study sought DNA evidence of candidate organisms in archival prostate cancer tissues with the aim of assessing if a subset of these cancers show any association with common genital infections.Methods221 archival paraffin-embedded tissue blocks representing 128 histopathologically confirmed prostate cancers comprising 52 “aggressive” (Gleason score ≥ 7) and 76 “non-aggressive” (Gleason score ≤ 6) TURP or radical prostatectomy specimens were examined, as well as unaffected adjacent tissue when available. Representative tissue sections were subjected to DNA extraction, quality tested and screened by PCR for HSV-1, HSV-2, XMRV, BKV, HPV, Chlamydia trachomatis, Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma genitalium, and Trichomonas vaginalis.Results195 of 221 DNA samples representing 49 “aggressive” and 66 “non-aggressive” prostate cancer cases were suitable for analysis after DNA quality assessment. Overall, 12.2% (6/49) aggressive and 7.6% (5/66) non-aggressive cases were positive for any of the candidate organisms. Mycoplasma genitalium DNA was detected in 4/66 non-aggressive, 5/49 aggressive cancers and in one cancer-unaffected adjacent tissue block of an aggressive case. Ureaplasma urealyticum DNA was detected in 0/66 non-aggressive and 1/49 aggressive cancers and HSV DNA in 1/66 non-aggressive and 0/49 aggressive cancers. This study did not detect BKV, XMRV, T. vaginalis, U. parvum, C. trachomatis or HPV DNA.ConclusionsThe low prevalence of detectable microbial DNA makes it unlikely that persistent infection by the selected candidate microorganisms contribute to prostate cancer risk, regardless of tumour phenotype.

Clinicopathological study of prostatic biopsies.

Prostatism is a common malady in the geriatric age group. Benign prostatic hyperplasia and Carcinoma of the prostate are increasingly frequent with advancing age. The aim of the present study is to study the spectrum of prostatic lesions among the biopsies received in a rural hospital. One hundred and six cases of prostatic biopsies received in the Department of Pathology, Rajah Muthiah Medical College and Hospital - Annamalai University were included in the present study. There were 44 needle biopsies and 62 TURP specimens. All the specimens were fixed in 10% neutral buffered formalin and 5μ sections were stained with Hematoxylin and Eosin stain (H & E stain). Relevant clinical data including age, the presenting complaints and S.PSA values in suspected cases of carcinoma prostate were recorded. Among the 106 biopsies received, 79 (74.52%) cases were of Benign prostatic hyperplasia, two cases (1.89%) were Prostatic intraepithelial neoplasia and 25 cases (23.58%) were Carcinoma of Prostate. Prostatitis was the most common associated lesion in cases of benign prostatic hyperplasia presenting in 25.31% patients. Among the Carcinoma patients, 20 cases (80%) were of Adenocarcinoma of prostate and 5 cases (20%) were Small cell carcinoma of prostate. Both Benign prostatic hyperplasia and Carcinoma prostate were common in the seventh decade. Most common clinical presentation was difficulty in micturition. Most common histological type of Carcinoma prostate was Adenocarcinoma. Serum PSA estimation was done in 49 cases of prostate biopsies. Elevations of serum PSA levels were noted in both BPH and Carcinoma prostate patients.Eight cases of BPH, had serum PSA values in the range of 0-4ng/ml. Six cases of Carcinoma prostate ,had serum PSA values in the range of >80 ng/ml. Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. Although, investigations like transrectal ultrasonogram and serum PSA estimation aids in diagnosis, a definitive diagnosis of benign and malignant lesions of prostate can be made by histopathological study of prostatic biopsies.

S40 Difference between actual vs. pathology prostate weight in TURP and radical robotic-assisted prostatectomy specimen

S40 Difference between actual vs. pathology prostate weight in TURP and radical robotic-assisted prostatectomy specimen

尿細胞診中に出現した前立腺導管腺癌の 1 例

We report herein on a case of prostatic duct adenocarcinoma in a 74-year-old man, who presented with urinary retention. A cytology specimen obtained by catheterization showed loose clusters or aggregates composed of small round to oval cells. These cells revealed fine chromatin with prominent nucleoli. A TUR-P specimen revealed adenocarcinoma with a papillary pattern. The immunohistochemical analysis revealed that these tumor cells were positive for PSA and PAP. Although it is rare, prostatic duct adenocarcinoma cells can be observed in urine specimens, therefore it should be kept in mind as a differential diagnosis. In addition, immunohistochemistry may be useful for such differential diagnoses.

Litiasis prostática: cálculos silentes

Introduction Introduction and Objectives Prostate stones are frequently encountered during transurethral resection of the prostate in urology practice. We aimed to demonstrate the physical and chemical properties of prostate stones. We also aimed to determine possible relationship between inflammation of prostate gland and prostate stones. Methods The consecutive patients (excluding subjects with PSA≥4 ng/ml and urolithiasis), who underwent TURP operation and who were observed to have prostatic calculi during TURP, were included in the study. The prostatic stones obtained from each patient during TURP were analysed for chemical composition and observed under electron microscopy (SEM) for structure and surface morphology. The pathological specimens were assessed by the uropathologist for the final diagnosis and existence and degree of inflammation. Results Five patients were included in the study. From each patient at least three (range 3–8) samples of stones (diameter varying from 1 mm up to 5 mm) were obtained. The stones were made of mixed composition of calcium phosphate and calcium carbonate. The stones were found to have lobular surface made up of small spheres under SEM. Histopathological examination of the TURP specimens revealed being prostatic hyperplasia accompanied with inflammation of mild to severe degree. Conclusions Prostatic stones are concentrically precipitated calcium stones within the prostatic ductuli with granular grape like morphology. Histopathological inflammation seems to be associated with these prostatic calculi.

Prostatic calculi: Silent stones

Introduction and objectivesProstate stones are frequently encountered during transurethral resection of the prostate in urology practice. We aimed to demonstrate the physical and chemical properties of prostate stones. We also aimed to determine possible relationship between inflammation of prostate gland and prostate stones. MethodsThe consecutive patients (excluding subjects with PSA≥4ng/ml and urolithiasis), who underwent TURP operation and who were observed to have prostatic calculi during TURP, were included in the study. The prostatic stones obtained from each patient during TURP were analysed for chemical composition and observed under electron microscopy (SEM) for structure and surface morphology. The pathological specimens were assessed by the uropathologist for the final diagnosis and existence and degree of inflammation. ResultsFive patients were included in the study. From each patient at least three (range 3–8) samples of stones (diameter varying from 1mm up to 5mm) were obtained. The stones were made of mixed composition of calcium phosphate and calcium carbonate. The stones were found to have lobular surface made up of small spheres under SEM. Histopathological examination of the TURP specimens revealed benign prostatic hyperplasia accompanied with inflammation of mild to severe degree. ConclusionsProstatic stones are concentrically precipitated calcium stones within the prostatic ductuli with granular grape-like morphology. Histopathological inflammation seems to be associated with these prostatic calculi.