Cytomorphologic diagnostic criteria adenocarcinoma in prostate needle biopsies and their prognostic importance

Öz

Introduction: Diagnostic criteria of adenocarcinoma in needle biopsies and relation between these and tumour Materials and methods: Fifty five (55) adenocarcinoma cases in prostate needle biopsies were examined for prominent nucleoli, nuclear enlargement, mitosis, intraluminal eosinofilic secretion, basophilic mucin, amphophilic cytoplasm, intraluminal crystaloid, perineural invasion by the light microscope. The relation between diagnostic criteria and Gleason grading were studied. Results: The most frequent criteria were as follows: nuclear enlargement, prominent nucleoli and intraluminal eozinofilic secretion. Intraluminal crystalloid and basophilic mucin were seen occasionally. The relation between intraluminal crystalloid and Gleason grading has been defined as inversely proportional. The relation between the other criteria and Gleason grading has no statistical correlation. In our study we evaluated that perineural invasion, extra prostatic invasion and Gleason grading were prognostically important criteria. Conclusion: In order to define prostate adenocarcinoma all of cytomorphologic criteria should be evaluated and interpreted. We suggested that perineural invasion, extraprostatic invasion and Gleason grading should be expressed in the reports of needle biopsies which are important for staging, planning of treatment and prognosis

Anahtar Kelimeler

• Prostate adenocarcinoma, differential diagnosis, prognosis

Prostat iğne biyopsilerinde adenokarsinom sitomorfolojik tanı bulguları ve prognostik önemi

Öz

Giriş ve amaç: Prostat iğne biopsilerinde adenokarsinom tanı bulguları gözden geçirilerek ve bunların tümör derecesi ile ilişkileri incelenerek, prognostik öneme grading has been examined and prognostic importance sahip olan tanı bulguları irdelendi. of diagnostic criteria has been evaluated. Gereç ve yöntem: Ellibeş (55) adet adenokarsinoma tanısı almış prostat iğne biopsisi ışık mikroskobunda nükleol belirginliği, nükleer büyüme, mitoz, intraluminal eozinofilik sekresyon ve bazofilik musin varlığı, amfofilik sitoplazma, intaluminal kristaloit, perinöral invazyon açısından değerlendirildi. Tanısal bulguların Gleason derecesi ile ilişkileri incelendi. Bulgular: Nükleer büyüme, nükleol belirginliği ve intraluminal eozinofilik sekresyon sırayla en sık izlenen tanı bulguları oldu. En az görülen tanı bulguları intraluminal kristaloit ve bazofilik musin varlığıdır. Kristaloit oluşumu ile Gleason derecesi arasında ters orantı izlenirken diğer bulgularla Gleason derecesi arasında istatiksel olarak anlamlı ilişki saptanmadı. Prognoz açısından önemli olan bulguların perinöral invazyon, prostat dışı doku invazyonu ile Gleason derecesi olduğu görüldü. Sonuç: Prostat adenokarsinomu tanısına tüm sitomorfolojik bulguların beraberce değerlendirilmesi ile varılabilir. Evrelendirme, sağaltım planması ve prognoz açısından önemli olan perinöral invazyon, prostat dışı doku invazyon bulgusu ile Gleason derecesinin iğne biopsi raporlarında belirtilmesinin yararlı olacağı gözükmektedir

Anahtar Kelimeler

• Prostat adenokarsinomu, ayırıcı tanı, prognoz

Kaynakça

1. Brawer MK, Peehl DM, Stamey TA, Bostwick DG. Keratin immunoreactivity in the benign and neoplastic human prostate. Cancer Research 1985; 45: 3663-3667.
2. Gittes RF. Carcinoma of the prostate. The New Engl J of Med 1991; 324(4): 236-245.
3. Mohler J, Partin AW, Epstein JI et al. Prediction of prognosis in untreated stage A2 prostatic carcinoma. Cancer 1992; 69: 511- 5
4. Petersen RO. Urologic Pathology. 2.baskı. Philadelphia: JB Lippincott, 1992; 575-648.
5. Weidner N, Carrol PR, Flax J, Blumenfeld W, Folkman J. Tumor angiogenesis correlates with metastasis in invasive prostate carcinoma. Am J Pathol 1993,143: 401-409.
6. Zaridze DG, Boyle P. Cancer of the prostate. Epidemiology and aetiology. Brit J of Urology 1987;59: 493-502.
7. Epstein JI. Diagnostic criteria of limited adenocarcinoma of the prostate on needle biopsy. Hum Pathol 1995; 26: 223-229.
8. Algaba F, Epstein JI, Aldape HC et al. Assesment of prostate carcinoma in core needle biopsy. Cancer 1996; 78 (2): 376- 3

9. Epstein JI. The diagnosis and reporting of adenocarcinoma of the prostate in core needle biopsy specimens.Cancer 1996;78 (2): 350-356.
10. Bostwick DG. Grading of prostatic cancer. Am J Clin Pathol 1993; 102(1): 38-56.
11. Molberg KH, Mıkhail A, Vuıtch F. Crystalloids in metastatic prostatic carcinoma. 1994;Am J Clin Pathol 101: 266-268.
12. Kelemen PR, Buschmann RJ, Weisz-Carrington P. Nucleolar prominence as a diagnostic variable in prostatic carcinoma. Cancer 1990; 65: 1017-1020..
13. Mostofi FK, Sesterhenn IA, Davis CJ. A pathologist's view of prostatic carcinoma. Cancer Supplement 1993; 71(3): 906-936.
14. Mostofi FK, Sesterhenn IA, Davis CJ. Prostatic Carcinoma: Problems in the interpretation of prostatic biopsies. Human Pathology 1992; 23(3): 223-240.
15. Damjanov I, Linder J. Anderson's Pathology. 10.baskı. Misssouri: Mosby,1996; 2: 2197-2222.
16. Varma M, Lee MW, Tambol P et al. Morphologic cirteria for the diagnosis of prostatic adenocarcinoma in needle biopsy specimens. Arch Pathol Lab Med 2002; 126: 554-561.
17. Helpap B. Observation on the number, size and localization of nucleoli in hyperplastic and neoplastic prostatic disease. Histopathology 1988; 13: 203-211.
18. Montironi R, Braccishi A, Matera G, Scarpelli M, Pisani E. Quantation of the prostatic intraepithelial neoplasia: Analysis of the nucleolar size, number and location. Path. Res. Pract 1991; 187: 307-314.
19. Bostwick DG, Wollan P, Adlakha K. Collagenous micronodules in prostate cancer: A spesific but infrequent diagnostic finding. Arch Pathol Lab Med 1995;119: 444-447.
20. Benett B D. Prostatic crystalloids. JAMA 1988; 260 (15): 2287.
21. Ro JY, Grignon DJ, Tronsoco P, Ayala AG. Intraluminal crystalloids in whole organ sections of prostate. The Prostate 1988; 13: 233- 239.
22. Ro JY, Ayala AG, Ordonez NG et al. Intraluminal crystalloids in prostatic adenocarcinoma. Cancer 1986; 57: 2397-2407.
23. Rosario AD, Buı HX, Abdulla M, Ross JS. Sulfur-rich prostatic intraluminal crystalloids: A surgical pathologic and electron probe X ray microanalytic study. Hum Pathol 1993; 24: 1159- 11
24. Hennebery JM, Kahane H, Humphrey PA, Keetch DW, Epstein JI. The significance of intraluminal crystalloids in benign prostate glands on needle biopsy. Am J Surg Pathol 1997; 21 (6): 725-728.
25. Anton RC,Chakraborty S, Wheeler TM. The significance of intraluminal prostatic crystalloids in benign needle biopsies. Am J Surg Pathol 1997; 22(4): 446-449.
26. Baisden BL, Kahane H, Epstein JI. Perineural invasion,,mucinous fibroplasia, and glomerulation: diagnostic features of limited cancer on prostate needle biopsy. Am J Surg Pathol 1999; 23(8): 918-924.
27. Bastacky SI, Walsh PC, Epstein JI. Relationship between perineural tumor invasion on needle biopsy and radical prostatectomy capsular penetration in clinical stage B adenocarcinoma of the prostate. Am J Surg Pathol 1993; 17(4): 336-341.
28. Humphrey PA. Gleason grading and prognostic factors in carcinoma of the prostate. Mod Pathol 2004; 17 (3): 307-315.
29. Epstein JI. Diagnosis and reporting of limited adenocarcinoma of the prostate on needle biopsy. Mod Pathol 2004; 17(3): 292- 30