Histopathology reporting of prostate needle biopsies. 2005 update

Abstract

This report reviews the diagnostic and prognostic importance of the pathologic findings in prostate needle biopsies. The morphological findings of the needle biopsy may be placed into one of the following five categories: prostate cancer, atypical small acinar proliferation, high-grade prostatic intraepithelial neoplasia, inflammation, and benign prostatic tissue. While the prime goal of the biopsy is to diagnose prostatic adenocarcinoma, once carcinoma is detected, further descriptive information regarding the type, amount of cancer, and grade forms the cornerstone for contemporary management of the patient and for assessment of the potential for local cure and the risk for distant metastasis. The information provided in the needle biopsy report regarding the attributes of carcinoma is used depending on the individual patient's medical condition and preference and on the treating physician's evaluation to determine whether any form of treatment is indicated and, if so, the type of therapy.

Biopsy sampling and histopathological markers for diagnosis of prostate cancer

“…Detection of PCa was classically dependent on digital rectal examination (DRE), but owing to the development of more reliable methods of screening, especially the widespread use of serum prostatespecific antigen (PSA) testing, and imageguided needle core biopsy (e.g., transrectal ultrasound [TRUS] and, more recently, MRI), the accuracy to diagnose PCa at its earliest stages has significantly increased [2]. The advent of PSA screening was associated with an increase in PCa incidence and, probably, a decrease in cancer-related mortality, as well [3].…”

Role of inflammasomes and their regulators in prostate cancer initiation, progression and metastasis

“…Nonetheless, inflammatory atrophy was found in about 40% of the adenocarcinoma cores in that study. Other studies report no significant association between prostatic inflammatory atrophy (PIA) and prostate cancer development [11,12]. PIA can be diffuse or focal, and the detection of small focal changes occurring at the peripheral zone is challenging in needle biopsies [13].…”

Microvessel density in Prostatic Lesions : Relevance to prognosis

“…3 Diagnosis of carcinoma can also be aided by preoperative prostatic specific antigen (PSA) estimation and use of imaging studies coupled with clinical examination while biopsy remains the gold standard in confirming a carcinoma. 3 Besides reporting cancer and grading it, there are number of other features, which add to the predictive value, which may be included in the routine reporting of cancers; one such feature is estimation of MVD. Most studies have shown a positive correlation of MVD with increasing pathological grade 4,5 , while some other studies have found out that MVD is an independent predictor of cancer progression and survival.…”