The objective of this work was to assess the correlation between microvessel density (MVD), pathological stage and disease recurrence in a series of patients who underwent radical prostatectomy for prostate cancer. Pathological material from 75 consecutive radical prostatectomies performed before 1994 without neoadjuvant treatment, in which sufficient follow-up data were available, was reexamined. Paraffin embedded material was re-cut and hematoxylin and eosin (H&E) stained. Areas of maximal angiogenesis within tumor were identified. Expression of CD34 was investigated by using the monoclonal antibody MY 10. Within the areas of maximal angiogenesis, microvessels expressing CD34 were counted and specimens were divided into two groups, one showing a count of less than 90 microvessels per microscopic field at 2006magnification (MVD < 90), the second more than 90 microvessels (MVD > 90). The MVD was then related to pathological stage, Gleason score (GS) and outcome of the disease. Mean followup was 84 months. Clinical or biochemical progression was observed in 38.6% of patients. In low GS cases, MVD was always < 90, whereas in GS 5 -6, half had MVD < 90 and half were > 90. In high GS MVD was always > 90. MVD was positively associated with a higher pathological stage. Progression of the disease was observed in 20% of MVD < 90 and in 51% in MVD > 90 (P ¼ 0.006). MantelHaensz test showed a correlation between MVD and time to progression (P < 0.05). Although problems exist in methods of counting and in the cut-off number of vessels, which can discriminate the risk categories, it may be concluded that microvessel counts, using CD34 monoclonal antibody, can accurately predict the outcome of radical prostatectomy.

ObjectivesTo assess the ability of Real-time Elastography (RTE) to differentiate malignant from benign testicular lesions.MethodsIn 88 testicles ultrasound identified 144 lesions, which were examined by RTE. Elasticity images of the lesions were assigned the colour-coded score of Itoh (Radiology 2006), according to the distribution of strain induced by light compression. RTE findings were analysed considering shape (nodular/pseudo-nodular), size (<5 mm, 6–10 mm, >11 mm) and score (SC1-5) of the lesions.Results93.7% of all benign lesions showed a complete elastic pattern (SC1). 92.9% of benign nodules <5 mm and 100% of the pseudonodules showed a nearly complete elastic pattern (mainly SC1). 87.5% of malignant nodules showed a stiff pattern (SC4-5). RTE gave 87.5% sensitivity, 98.2% specificity, 93.3% positive predictive value, 96.4% negative predictive value and 95.8% accuracy in differentiating malignant from benign lesions.ConclusionsRTE is a useful technique in assessing small testicular nodules and pseudo-nodules. This is relevant in clinical practice allowing expectant management in RTE selected cases. The role of RTE seems less relevant for larger lesions because most of them are malignant at clinical and ultrasound assessment, limiting RTE to simply confirmation role.Key Points• An emerging role for Elastography in allowing surveillance for small testicular lesions• Elastography can better differentiate benign from malignant testicular lesions• Follow up can be reduced for elastic testicular lesions at Elastography.

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