Small Cell-like Change in Central Zone Histology—A New Observation Mimicking Cribriform Intraductal Prostatic Adenocarcinoma

2021 ◽  
pp. 106689692110039
Author(s):  
Oleksandr N. Kryvenko
Keyword(s):  
Prostate Cancer ◽  
Central Zone ◽  
Intraepithelial Neoplasia ◽  
Small Cell ◽  
Prostatic Adenocarcinoma ◽  
Grade Group ◽  
Ki 67 ◽  
Neoplastic Process ◽  
Treatment Naïve ◽  
Group 3

A small cell-like change in prostate has been described in high-grade prostatic intraepithelial neoplasia (PIN), intraductal prostatic adenocarcinoma, and invasive prostate cancer. It occurs when these processes have a cribriform architecture. To date, small cell-like change has not been described in benign glands. Herein, I describe such a change in cribriform central zone histology from a radical prostatectomy with a spatially remote treatment naïve Grade Group 3 prostate cancer. The cancer did not have cribriform morphology or intraductal prostatic adenocarcinoma. The small cell-like change was positive for racemase in PIN-4 cocktail and no nuclei were highlighted by Ki-67. This is the first report of a small cell-like change in benign prostate tissue. Although rare, such finding in cribriform architecture of central zone histology can potentially be misinterpreted as a neoplastic process.

scholarly journals The prevalence and locations of bone metastases using whole-body MRI in treatment-naïve intermediate- and high-risk prostate cancer

2020 ◽  
Author(s):  
Fredrik Ottosson ◽  
Eduard Baco ◽  
Peter M. Lauritzen ◽  
Erik Rud
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Bone Metastases ◽  
Whole Body ◽  
Gleason Grade ◽  
Grade Group ◽  
Whole Body Mri ◽  
High Risk Prostate Cancer ◽  
Treatment Naïve ◽  
Group 3

Abstract Objective The aim of this study was to assess the prevalence and distribution of bone metastases in treatment-naïve prostate cancer patients eligible for a metastatic workup using whole-body MRI, and to evaluate the results in light of current guidelines. Methods This single-institution, retrospective study included all patients with treatment-naïve prostate cancer referred to whole-body MRI during 2016 and 2017. All were eligible for a metastatic workup according to the guidelines: PSA > 20 ng/ml and/or Gleason grade group ≥ 3 and/or cT ≥ 2c and/or bone symptoms. The definition of a metastasis was descriptive and based on the original MRI reports. The anatomical location of metastases was registered. Results We included 161 patients with newly diagnosed prostate cancer of which 36 (22%) were intermediate-risk and 125 (78%) were high-risk. The median age and PSA were 71 years (IQR 64–76) and 13 ng/ml (IQR 8–28), respectively. Bone metastases were found in 12 patients (7%, 95% CI: 4–13), and all were high-risk with Gleason grade group ≥ 4. The pelvis was affected in 4 patients, and the spine + pelvis in the remaining 8. No patients demonstrated metastases to the spine without concomitant metastases in the pelvis. Limitations are the small number of metastases and retrospective design. Conclusion This study suggests that the overall prevalence of bone metastases using the current guidelines for screening is quite low. No metastases were seen in the case of Gleason grade group ≤ 3, and further studies should investigate if it necessary to screen non-high-risk patients. Key Points • The overall prevalence of bone metastases was 7% in the case of newly diagnosed intermediate- and high-risk prostate cancer. • The prevalence in high-risk patients was 10%, and no metastases were seen in patients with Gleason grade group ≤ 3. • The pelvic skeleton is the main site, and no metastases occurred in the spine without concomitant pelvic metastases.

scholarly journals Impact of Vasectomy on the Development and Progression of Prostate Cancer: Preclinical Evidence

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2295
Author(s):  
Takashi Kawahara ◽  
Yuki Teramoto ◽  
Yi Li ◽  
Hitoshi Ishiguro ◽  
Jennifer Gordetsky ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Intraepithelial Neoplasia ◽  
Underlying Mechanism ◽  
Grade Group ◽  
History Of ◽  
Poorly Differentiated ◽  
Group 3 ◽  
Prostate Cancers ◽  
The Impact ◽  
Tramp Mice

Some observational studies have implied a link between vasectomy and an elevated risk of prostate cancer. We investigated the impact of vasectomy on prostate cancer outgrowth, mainly using preclinical models. Neoplastic changes in the prostate were compared in transgenic TRAMP mice that underwent vasectomy vs. sham surgery performed at 4 weeks of age. One of the molecules identified by DNA microarray (i.e., ZKSCAN3) was then assessed in radical prostatectomy specimens and human prostate cancer lines. At 24 weeks, gross tumor (p = 0.089) and poorly differentiated adenocarcinoma (p = 0.036) occurred more often in vasectomized mice. Vasectomy significantly induced ZKSCAN3 expression in prostate tissues from C57BL/6 mice and prostate cancers from TRAMP mice. Immunohistochemistry showed increased ZKSCAN3 expression in adenocarcinoma vs. prostatic intraepithelial neoplasia (PIN), PIN vs. non-neoplastic prostate, Grade Group ≥3 vs. ≤2 tumors, pT3 vs. pT2 tumors, pN1 vs. pN0 tumors, and prostate cancer from patients with a history of vasectomy. Additionally, strong (2+/3+) ZKSCAN3 expression (p = 0.002), as an independent prognosticator, or vasectomy (p = 0.072) was associated with the risk of tumor recurrence. In prostate cancer lines, ZKSCAN3 silencing resulted in significant decreases in cell proliferation/migration/invasion. These findings suggest that there might be an association between vasectomy and the development and progression of prostate cancer, with up-regulation of ZKSCAN3 expression as a potential underlying mechanism.

scholarly journals Immunohistochemical expression of Nanog protein in prostate cancer cells of distinct grade groups

2020 ◽  
Author(s):  
GYu Kudryavtsev ◽  
LV Kudryavtseva ◽  
LM Mikhaleva ◽  
YaYu Kudryavtseva ◽  
NA Solovyeva ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Cells ◽  
Rank Correlation ◽  
Morphological Characteristics ◽  
Screening Tests ◽  
Prostate Cancer Cells ◽  
Grade Group ◽  
Ki 67 ◽  
Cancer Management ◽  
Grade Groups

Prostate cancer is the most common type of cancer among men, which is mainly due to extensive use of screening tests and high total number of prostate biopsies. Verification of tumors with poorer prognosis is the primary goal of prostate cancer management. The study was aimed to determine the clinical and morphological associations and the prognostic value of the Nanog protein expression in prostate cancer of distinct Grade Groups. We used the prostate tissue specimens obtained during surgery, and the biopsy specimens, the total of 89 cases. Histological and immunohistochemical assessment was performed using antibodies to Ki-67 and Nanog. Correlations between the expression of markers and the Grade Groups were revealed using the Spearman's rank correlation coefficient, and the correlation with clinical and morphological characteristics was determined using the chi-squared test (χ2). There was a positive correlation between the expression of Ki-67 and Nanog, and the Grade Group numerical order (rs = 0.619, p < 0.001 and rs = 0.786, p < 0.001 respectively). We managed to find the relationship between the high Nanog expression and the extraprostatic extension (p = 0.041). High expression of Nanog protein in the prostate cancer cells was associated with a higher-grade adenocarcinoma and indicated a poor prognosis.

The impact of tertiary Gleason pattern 5 in the grade group system on recurrence following radical prostatectomy in patients with prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 44-44
Author(s):  
Masashi Kato ◽  
Toyonori Tsuzuki ◽  
Ryo Ishida ◽  
Tohru Kimura ◽  
Osamu Kamihira ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Grade Group ◽  
Group System ◽  
Gleason Pattern ◽  
Group 4 ◽  
Significant Difference ◽  
Psa Progression ◽  
Group 3 ◽  
Group 2

44 Background: The current ISUP/WHO grade group system classified the Gleason grade into five groups. Although presence of tertiary Gleason pattern 5 (tG5) reported to be related with unfavorable tumor characteristic, only a few data is available about influences on the grade group system of tG5 so far. In this study, we evaluated the effect of tG5 on recurrence following radical prostatectomy in patients with prostate cancer. Methods: We retrospectively evaluated 1,020 patients with prostate cancer who underwent radical prostatectomy without neoadjuvant therapy at the hospitals that the authors were affiliated with between 2005 and 2013. After excluding the patients with missing data or slides, 1000 patients were enrolled in this study. All prostatectomy specimen slides were reviewed by a single genitourinary pathologist according to ISUP 2014. Recurrence following radical prostatectomy was defined according to European Association of Urology guidelines. The endpoint was defined as an increase in PSA level. Results: Patient median age was 67 years (range 49–77 years). The median serum PSA was 6.9 ng/mL (range 0.4–82 ng/mL). The median follow-up period was 69 months (range 0.7–134 months). All the patients showed Group1:163 cases (16.3%), Group2: 436 (43.6%), Group 2 with tG5: 54 (5.4%), Group 3:121 (12.1%), Group 3 with tG5: 89 (8.9%), Group 4: 39 (3.9%), and Group 5: 98 (9.8%). PSA progression-free survival was significantly different among the five groups (Group1-5) (p = 0.0001). As concerning tG5, it showed significant difference between Group 2 and Group 2 with tG5 by using log rank test (p < 0.0001). Similarly, there was significant difference between Group 3 and Group 3 with tG5 (p = 0.001). On the other hand, there was no difference between Group 2 with tG5 and Group 3 (p = 0.916), and in the same way, no difference between Group 3 with tG5 and Group 4 (p = 0.854). Conclusions: The Presence of tG5 on the grade group system increase PSA progression following radical prostatectomy in patients with prostate cancer. Especially, Group 2 and 3 showed upgrade by presence of tG5. Integrating tG5 into the grade group system will improve the accuracy of patient outcome predictions.

Immune infiltrates and PD-L1 expression in treatment-naïve acinar prostatic adenocarcinoma: an exploratory analysis

2018 ◽  
Vol 71 (11) ◽  
pp. 1023-1027 ◽  
Author(s):  
Elan Hahn ◽  
Stanley K Liu ◽  
Danny Vesprini ◽  
Bin Xu ◽  
Michelle R Downes
Keyword(s):  
Prostate Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Lower Grade ◽  
Grade Group ◽  
Lower Stage ◽  
Cd163 Expression ◽  
Programmed Death ◽  
Treatment Naïve

Tumour-induced immunosuppression plays a role in the development and progression of cancer. Of interest is the interaction between programmed death-1 and programmed death ligand-1 (PD-L1) which can be targeted through immune checkpoint blockade; however, there are limited data surrounding the composition of the immune milieu in prostate cancer. We preliminarily assessed 21 radical prostatectomies in therapy-naïve patients for immune markers and PD-L1 expression. The immune infiltrates were higher in adenocarcinoma than benign prostate (lymphocytes p<0.001, macrophages p=0.010) with 5% of cases being PD-L1 high (≥5% expression). Increased peritumoural CD68 and CD163 expression correlated with lower grade group (GG) (p=0.024 and p=0.014, respectively) with a trend towards increased CD68 expression in lower stage cases (p=0.086). There was also increased CD45 expression in lower GGs (p=0.063). We found the immune infiltrate in acinar prostate cancer to be extremely heterogeneous with an overall immunophenotype unlikely to respond to immune checkpoint blockade.

scholarly journals MP62-14 TRANSPERINEAL PROSTATE BIOPSY IMPROVES THE DETECTION OF GRADE GROUP 3 OR HIGHER PROSTATE CANCER AMONG MEN ON ACTIVE SURVEILLANCE

2020 ◽  
Vol 203 ◽  
pp. e951
Author(s):  
Alexa Meyer* ◽  
Mufaddal Mamawala ◽  
Jared Winoker ◽  
Patricia Landis ◽  
Mohamad Allaf ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Prostate Biopsy ◽  
Grade Group ◽  
Transperineal Prostate Biopsy ◽  
Group 3

MRI targeted biopsy dramatically increases detection of clinically significant prostate cancer while reducing the risk of indolent cancer detection.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 108-108
Author(s):  
Michael Ahdoot ◽  
Amir H Lebastchi ◽  
Sandeep Gharam ◽  
Patrick H Gomella ◽  
John Dibianco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Prostate Volume ◽  
Targeted Biopsy ◽  
Grade Group ◽  
Patient Demographics ◽  
Sextant Biopsy ◽  
Group 3 ◽  
Male Patients ◽  
Clinically Significant

108 Background: MRI fusion prostate biopsy has been shown to improve detection of clinically significant prostate cancer, however the degree of this benefit is poorly characterized in large clinical trials. Methods: 1750 MRI targeted plus sextant biopsies were performed in 1742 male patients from 2007 to 2017. Patient demographics, PSA, prostate volume, primary and secondary Gleason scores, Johns Hopkins Grade Groups, number of MRI targeted lesions, number of cores obtained, and biopsy yield were recorded. Results: The patient population consisted of men averaging 62.9-year-old (36-86) with a mean PSA 9.6ng/mL, and prostate volume of 59.2 ml. A total of 804 cancers were detected on sextant biopsy and 839 were detected on MRI targeted biopsy. Relative to targeted biopsy, sextant biopsy detected only significantly more Gleason 6 disease (14% vs 21.5%, p < 0.0001) than targeted biopsy. Targeted biopsy detected more Gleason 7 (21% vs 16.6%, p = 0.0009) and Gleason 8-10 (13.4% vs 9.4%). Additionally, Gleason 7 sub-stratification demonstrated substantially more Gleason 4+3 detection in targeted group vs sextant biopsy (4% vs 0.5%, p < 0.0001). When stratified by Grade Group targeted biopsy detected 76% more Grade Group 3-5 cancers (p < 0.0001) and 17.7% less Gleason Group 1-2 cancers (p < 0.0001). Only 1.7% of Grade Group 3-5 cancers were detected on sextant biopsy alone, where as 15.7% of Grade Group 3-5 cancers were detected on targeted biopsy alone. Conclusions: MRI targeted biopsy significantly increases the likelihood of detecting clinically significant cancer and decreases the risk of indolent cancer detection. These finding strongly support the use of MRI targeted biopsy when possible.

Optimal sampling of pelvic lymphadenectomy specimens following radical prostatectomy: is complete tissue submission justified?

2019 ◽  
Vol 72 (10) ◽  
pp. 712-715 ◽  
Author(s):  
Sarah Ni Mhaolcatha ◽  
Elaine Power ◽  
Nick Mayer ◽  
Susan Prendeville
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Primary Tumour ◽  
Pelvic Lymphadenectomy ◽  
Optimal Sampling ◽  
Fatty Tissue ◽  
Grade Group ◽  
Optimal Method ◽  
Group 3 ◽  
The Impact

There is currently no consensus among pathologists on the optimal method of sampling pelvic lympadenectomy specimens (PLND) in prostate cancer. We evaluated the impact of complete PLND submission on lymph node (LN) yield, detection of metastasis and laboratory workload in a series of 141 cases. Following isolation of grossly identifiable LNs/potential LNs, the remaining fatty tissue was embedded in toto. Complete PLND submission increased median LN yield from 10 (1–42) to 17 (3–57). Metastatic deposits were identified in nine non-palpable LNs, which altered the pN category in four cases (3%). The primary tumour (pT) was grade group ≥3 and/or pT3 at radical prostatectomy in 96% of pN+ cases. A median of seven additional blocks (1–28) was required for complete tissue embedding. Our findings indicate that submission of the entire fat can optimise PLND assessment but has a significant impact on laboratory workload. Complete submission of selected high-risk cases may be a reasonable alternative.

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