Carcinoma and dysplastic lesions of the prostate

Kastendieck, H.; Altenähr, E.; Hüsselmann, H.; M, Bressel

doi:10.1007/bf00284745

Cited by 22 publications

(1 citation statement)

References 32 publications

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“…The prostates were fixed in 10% formalin for at least one week. The prostates were completely sectioned at 3 mm intervals perpendicular to the urethra as had been described by Kastendeick et al 2 An average of eight complete cross sections were obtained from each prostate. The prostates were processed in the nonnal way, cut at a thickness of Accepted for publication 3 November 1988 5 tm, placed on large slides, stained with haematoxylin and eosin and studied microscopically.…”

Section: Methodsmentioning

confidence: 99%

Atypical hyperplasia in prostates of 20 to 40 year old men.

Brawn

Speights²,

Contin³

et al. 1989

J Clin Pathol

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SUMMARY One hundred prostates from 20 to 40 year old men obtained at necropsy were completely sectioned and studied microscopically. Atypical hyperplasia was found in 10 (20%) of 20-29 year old men and in 12 (24%) of 30-40 year old men. The prostates with atypical hyperplasia had similar weights as those without, and the atypical hyperplasia was most common in the lateral lobes of the prostate and near the apex. The atypical hyperplasias were (i) usually mild in degree rather than moderate or severe; (ii) almost equally divided between circumscribed and "infiltrating" lesions; (iii) usually occurred as multiple foci within the same prostate rather than as a single focus of atypical hyperplasia; and (iv) were not associated with inflammation.The finding that atypical hyperplasia is common in men between the ages of 20 and 40 years may be helpful in increasing the understanding of the histopathology of the prostate.Atypical hyperplasia has been identified in prostates from men under the age of 30.' As far as we know there has been no other study in which the prostates of young adult men were completely sectioned to determine the prevalence, location, and other common features of atypical hyperplasia. Material and methodsFifty consecutive prostates from 20-29 year old men and 50 from 30-40 year old men were collected from two medical examiner offices and from the necropsy service of a Veterans Administration Hospital. All of the necropsy specimens were collected and studied in accordance with appropriate hospital and state regulations. None of the men, as far as could be determined, was known to have had prostate carcinoma.The prostates were weighed to include the attached seminal vesicles and a 1 cm margin of bladder at the bladder neck. The prostates were fixed in 10% formalin for at least one week. The prostates were completely sectioned at 3 mm intervals perpendicular to the urethra as had been described by Kastendeick et al.2 An average of eight complete cross sections were obtained from each prostate. The prostates were processed in the nonnal way, cut at a thickness of Accepted for publication 3 November 1988 5 tm, placed on large slides, stained with haematoxylin and eosin and studied microscopically.The prostates were divided into the distal, middle and proximal thirds to identify the location of the atypical hyperplasia. The distal third contains the apex of the prostate and, the proximal third the base of the prostate. The prostates were also divided into three roughly equal concentric zones: the central zone adjacent to the urethra; the peripheral zone adjacent to the surgical capsule of the prostate; and the middle zone. The prostates were also divided into posterior,

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Section: Methodsmentioning

confidence: 99%

Atypical hyperplasia in prostates of 20 to 40 year old men.

Brawn

Speights²,

Contin³

et al. 1989

J Clin Pathol

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Large acinar atypical hyperplasia and carcinoma of the prostate

Kovi¹,

Mostofi²,

Heshmat³

et al. 1988

Cancer

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Step-sections of 429 whole prostate glands were studied. Large acinar atypical hyperplasia was graded as mild, moderate, and severe based on the degree of cellular anaplasia. The relationship between atypical hyperplasia and prostatic carcinoma was investigated. There was a strong association between prevalence and grade of atypical hyperplasia and prostatic carcinoma in patients up to 60 years old. Beyond the age of 60 no association was detected. In the younger age groups (36 to 60 years) atypical hyperplasia was found in 86.8% of prostates with carcinoma, but only in 37.9% of benign glands. Corresponding figures for the over-60 age group were 68.8% and 65.1%, respectively. A biologic explanation of the association between atypical hyperplasia and carcinoma in the younger age groups has been proposed. It was suggested that these men with atypical hyperplasia, particularly with severe atypical hyperplasia, have a greater risk for developing prostatic carcinoma.

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Prostate cancer: Transrectal ultrasound and pathology comparison. A preliminary study of outer gland (peripheral and central zones) and inner gland (transition zone) cancer

Lee¹,

Torp‐Pedersen²,

Mitchell³

et al. 1991

Cancer

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A study was conducted to compare results of transrectal ultrasound with pathologic findings on 116 patients who underwent radical prostatectomy for treatment of prostate cancer. In 96% (111 of 116), transrectal ultrasound guided biopsies of a hypoechoic lesion proved cancer; seven patients had known Stage A cancer; one patient had cancer detected by palpation and not detected by ultrasound. Cancers in the outer gland (peripheral and central zones) were compared with cancers in the inner gland (transition zone) by both ultrasound and pathology. Forty-eight percent (52 of 108) of cancers originating in the outer gland showed extraprostatic extension (Stage C disease). The primary sites of tumor escape from the outer gland were the prostatic capsule (38%), anterior fibromuscular stroma (5%), seminal vesicle (18%), the base of the gland at the neurovascular bundle (21%), and the apex (31%). Twenty-two percent (17 of 54) of cancers originating in the inner gland (transition zone) showed extraprostatic extension (Stage C disease). The primary sites of tumor escape from the inner gland were the anterior fibromuscular stroma (6%) and apex (11%). Both histologic and biologic differences between outer and inner gland cancers were found when tumor size was controlled. Gleason scores were significantly different for inner and outer gland cancers, with mean scores of 6.2 +/- 1.6 and 7.4 +/- 0.9, respectively. An odds ratio of 8.6 confirmed the increased risk of extraprostatic extension for outer gland cancer. Outer gland cancers showed increased aggressive behavior of both histologic and biologic nature. The difference in biologic aggressiveness of outer and inner gland cancers has definite implications for treatment options. Use of other diagnostic parameters, such as DNA ploidy, may help to determine which cancers to treat and when to treat them; this may have more relevance for cancers originating in the inner gland. Strategic transrectal ultrasound guided biopsy affords accurate tumor mapping and staging when modes of internal spread and escape of cancer from both outer and inner gland are known. Thus, transrectal ultrasound may be our "window of observation" through which additional research may explain the histologic and biologic discrepancies between outer and inner gland cancers.

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Carcinoma and dysplastic lesions of the prostate

Cited by 22 publications

References 32 publications

Atypical hyperplasia in prostates of 20 to 40 year old men.

Atypical hyperplasia in prostates of 20 to 40 year old men.

Large acinar atypical hyperplasia and carcinoma of the prostate

Prostate cancer: Transrectal ultrasound and pathology comparison. A preliminary study of outer gland (peripheral and central zones) and inner gland (transition zone) cancer

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