Prostate cancer pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Prostate cancer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Prostate Cancer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Staging
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Biopsy
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Alternative Therapy
Case Studies
Case #1
Prostate cancer pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Prostate cancer pathophysiology All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Prostate cancer pathophysiology
CDC on Prostate cancer pathophysiology
Prostate cancer pathophysiology in the news
Blogs on Prostate cancer pathophysiology
Directions to Hospitals Treating Prostate cancer
Risk calculators and risk factors for Prostate cancer pathophysiology

Overview

On microscopic histopathological analysis, increased gland density, small circular glands, basal cells lacking, and cytological abnormalities are characteristic findings of prostate cancer.

Pathogenisis

• Prostate cancer is classified as an adenocarcinoma, or glandular cancer. The region of prostate gland where the adenocarcinoma is most common is the peripheral zone.

• Initially, small clumps of cancer cells remain confined to otherwise normal prostate glands, a condition known as carcinoma in situ or prostatic intraepithelial neoplasia (PIN).

• Although there is no proof that PIN is a cancer precursor, it is closely associated with cancer. Over time these cancer cells begin to multiply and spread to the surrounding prostate tissue (the stroma) forming a tumor.

• Eventually, the tumor may grow large enough to invade nearby organs such as the seminal vesicles or the rectum, or the tumor cells may develop the ability to travel in the bloodstream and lymphatic system.

• Prostate cancer is considered a malignant tumor because it is a mass of cells which can invade other parts of the body. This invasion of other organs is called metastasis. Prostate cancer most commonly metastasizes to the bones, lymph nodes, rectum, and bladder.

When normal cells are damaged beyond repair, they are eliminated by apoptosis. Cancer cells avoid apoptosis and continue to multiply in an unregulated manner.

Gross Pathology

Prostate cancer is uncommonly apparent on gross.

Microscopic Pathology

Major criteria:

1.Architecture

• Increased gland density
• Small circular glands

• In rare subtypes - large branching glands

• "Infiltrative growth" pattern - malignant glands between benign ones

2.Basal cells lacking

3.Cytological abnormalities:

• Nuclear enlargement (subtle)
• Nucleoli (prominent)

Minor criteria:

• Nuclear hyperchromasia
• Wispy blue mucin
• Pink amorphous secretions
• Intraluminal crystalloid
• Amphophilic cytoplasm
• Adjacent High-grade prostatic intraepithelial neoplasia (HGPIN)
• Mitoses - quite rare

Prostate adenocarcinoma: Microscopic View

{{#ev:youtube|1SZPLS1dxTo}}

Gleason score

• See Gleason score

Prostate: Adenocarcinoma (Gleason grade 1)

{{#ev:youtube|F7V0Zl7a2FY}}

Prostate : Adenocarcinoma (Gleason grade 2)

{{#ev:youtube|YSOLiSklIXw}}

Prostate : Adenocarcinoma (Gleason grade 3)

{{#ev:youtube|TG8vR_pE7yA}}

Prostate: Adenocarcinoma (Gleason grade 4)

{{#ev:youtube|R2Cl4HScdGc}}

Prostate: Adenocarcinoma (Gleason grade 5)

{{#ev:youtube|F7V0Zl7a2FY}}