Premalignant lesions of prostate and their association with nodular hyperplasia and carcinoma prostate

Abstract

BACKGROUND:A relatively new development in the arena of prostatic histopathological study is the premalignant proliferative changes in the glandular epithelium, possibly relating to carcinoma. Two major categories have come up, namely prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH). AIMS: The aims of present study were to identify foci of the two putative premalignant conditions viz. PIN and AAH in ducto-acinar lining epithelia of 200 prostatectomy specimens and their association with nodular hyperplasia and adenocarcinoma prostate. MATERIAL AND METHODS: Micro sections from 200 prostatectomy specimens, received in the Department of Pathology, PGIMS, Rohtak, were extensively studied for the presence and association of premalignant conditions. Significant values were obtained by employing Chi-square (x 2 ) test, with P value <0.05 as significant. RESULTS: Out of 177 cases of nodular hyperplasia, 53 (29.9%) showed PIN and 38 (20.3%) showed presence of AAH. All 6 cases (100%) of pure carcinoma revealed foci of PIN. Out of the remaining 23 cases of carcinoma with nodular hyperplasia, foci of PIN were observed in 16 cases (94.1%) and AAH in 2 cases (11.7%). High-grade PIN was observed in 20 cases (86.9%) of the total 23 cases of carcinoma, with/without nodular hyperplasia and 20 cases (11.2%) of nodular hyperplasia. Low-grade PIN was observed in 33 cases (18.6%) of nodular hyperplasia and in only 1 case (5.8%) of carcinoma prostate with nodular hyperplasia. CONCLUSION: PIN, especially high-grade type was the most commonly observed premalignant lesion, in cases of adenocarcinoma, thereby suggesting it to be the likely precursor of carcinoma prostate. AAH showed a weaker association with carcinoma.

Evaluation of expression of immunohistochemical markers high molecular weight cytokeratin (HMWCK) and alpha-methylacyl coa racemose (AMACR) in prostatic needle biopsies and transurethral resection of prostate (TURP) specimen – A one year observational study

“…[6][7][8][9][10] In studies done by Kumaresan et al 4 and Shah RB et al, 11 the incidence of BPH with suspicious focus ranged from 26 -46%; in our study we found an incidence of 30%. Premalignant lesions like LGPIN and HGPIN in the present study had an incidence of 13.3% and 10% respectively which is similar to studies done by Rekhi et al 12 (11.2%) and Kumaresan et al8 (14.2%). The incidence of Prostate Adenocarcinoma was comparable to studies by Jasani et al, 13 Haroun et al, 14 Xie et al 9 and Shimada et al 10 A correlation between serum PSA levels and histopathological diagnosis was done in the present study which showed all the lesions have a raised (>4ng/mL) PSA levels with mean PSA value being higher in the Prostate Adenocarcinoma patients as compared to BPH and other pre-malignant entities.…”

Hepatotoxic effect of chronic exposure of Tacrolimus in male Albino rats

“…The toxic effect of Tacrolimus that appear in histopathological sections in liver may be due to the accumulations of active metabolits of Tacrolimus for long time as a result of repeated exposure for 90 days, as well as the long half live of drug (36 hrs.). Hyperplasia is multi proliferations of cells its considered precancerous lesions (31). The results indicated that the free radical that generated from the inhibition of the nitric oxide synthetas by Tacrolimus (32).…”

Histopathological study of prostatic lesions at a tertiary care hospital, Gujarat

“…Prostate cancer is responsible for 3% of all deaths in men above 55 years of age [5] . A relatively new development in the prostatic histopathology is the identification of premalignant conditions that can help in early diagnosis of prostate cancer [6] . A combination of digital rectal examination, transrectal ultrasonogram and needle biopsy can prove to be a powerful diagnostic tool in the routine diagnosis of benign and malignant prostatic lesions [7] .…”