The significance of intraluminal crystalloids in benign prostatic glands on needle biopsy.
ABSTRACT Based on data from autopsy, radical prostatectomy, and cystoprostatectomy specimens, it has been suggested that the finding of intraluminal crystalloids in benign glands on needle biopsy may indicate a concurrent carcinoma; therefore, repeat biopsy is recommended. We studied data from 56 consecutive needle biopsies from the Johns Hopkins Hospital and Dianon Systems in which the diagnosis of intraluminal crystalloids in benign glands was rendered and follow-up data were subsequently obtained. Cases in which crystalloids were present in glands suspicious for cancer, in glands of high-grade prostatic intraepithelial neoplasia, or in adenosis were excluded from the study. Follow-up data included repeat biopsy results and serum prostatic specific antigen levels. Of the 56 men, 31 (55%) had repeat biopsy (two underwent transurethral resection of the prostate [TURP]); the remaining men were either noncompliant or had medical conditions precluding subsequent biopsy. Of the 31 men who underwent repeat biopsies, 23 (74%) had benign diagnoses, one (3%) had high-grade prostatic intraepithelial neoplasia, and seven (23%) had adenocarcinoma. There was no difference in serum prostate-specific antigen values between those with and without cancer on repeat biopsy. In a control population of men with a benign first biopsy not showing crystalloids, the incidence of cancer on repeat biopsy was 16.2%, which was not statistically significantly different from the incidence found in our study group. We conclude that men with prostate biopsy results showing benign glands with crystalloids are at no significantly higher risk of having cancer on repeat biopsy than if crystalloids were not present.
- SourceAvailable from: redalyc.uaemex.mxRevista Urología Colombiana. 01/2005; XIV(3):55-61.
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ABSTRACT: This article provides an overview of the diagnosis of limited prostate cancer on needle biopsy. A few of the more common mimickers of prostate cancer, such as adenosis, partial atrophy, and high-grade prostatic intraepithelial neoplasia, are also covered. A systematic approach to diagnosing prostate cancer by evaluating architectural, nuclear, intraluminal and ancillary features is presented. The use of immunohistochemistry, including its pitfalls and limitations, is described and illustrated. By the use of a systematic diagnostic approach as outlined in this article, the threshold for diagnosing limited carcinoma of the prostate can be decreased. If a pathologist is not comfortable in diagnosing carcinoma in a particular small focus, this review will help them to recognize these foci as atypical and suspicious for carcinoma, so that further workup might lead to a more definitive diagnosis. Some of the more common situations leading to an atypical diagnosis have also been presented to help prevent the overdiagnosis of prostatic malignancy.Histopathology 01/2012; 60(1):28-40. · 2.86 Impact Factor
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ABSTRACT: In this paper we would like to present probably the first surgery performed on the prostate gland followed by microscopic analysis of the obtained tumor tissue sample. We based on the existing correspondence between Ludwig von Hammen and Johann N. Pechlin, and their successors in this field as well. Von Hammen seems to be a pioneer in the area of not only urological surgery but in directing this part of medical practice from “lithotomists” to physicians, much better educated than barbers in physiology but first of all in anatomy. This 17th century physician from Gdansk tried to set new standards both for surgical medical practice but histopathological examination of the excised material as well. Due to the change of the operational skills and procedures von Hammen's work got almost forgotten, but remains remembered due to the work of historians of the medicine from following centuries. Prostate. © 2014 Wiley Periodicals, Inc.The Prostate 08/2014; · 3.84 Impact Factor