The most common site of origin for prostate cancer…so - PowerPoint Presentation

Slide1

The most common site of origin for prostate cancer…so

perrectal

(PR)

exam is important

Origin for benign prostatic hyperplasia

(BPH)…so it mainly causes urinary obstructionSlide2
Slide3

Nodules in BPHSlide4

Corpora

amylacea

N

ormal

Columnar epithelial layer

Basal cell layer, present in benign and absent in malignant

Fibromuscular stroma…fibroblasts & smooth muscle cellsSlide5

A nodule formed of glands

The glands are large and branching

BPH

Some nodules are just: stromal nodulesSlide6

BPH

…high power

Corpora

amylacea

The cells are more in number with stratification

Large branching glandsSlide7

Multiple sections from a radical prostatectomy

…multiple yellowish lesions here represent carcinoma…note that the gland is not much enlargedSlide8

Prostatic adenocarcinoma

…small glands …crowded glands…decreased secretions

…absent basal layerSlide9

Prostatic carcinoma high grade (Gleason 5)

…poorly differentiated composed of infiltrating cells that are not forming glands…note the prominent nucleoli and the pleomorphic

enlarged nuclei Slide10

Normal testis

A

trophic testis…multiple causes . e.g., cryptorchidism, infection (e.g., mumps)…etc. Slide11

Spermatid (sesame-like)…so maturation is good

Different stages of spermatogenesis

Sertoli

cells at the periphery

Normal adult testis

A seminiferous tubuleSlide12

Prepubertal

testis…just sertoli cellsSlide13

Normal seminiferous tubules

Focal atrophy

Atrophic fibrotic tubules due to radiotherapy, infection…etc.Slide14

Only

sertoli

cells…no spermatogenesis

Atrophic testis

Note the thickening of tubular BM…this accompanies atrophySlide15

Hydrocele

…fluid around the testis…it

transilluminates

because it contains serous fluidBut a tumor or hematocele will not transilluminateSlide16

Testicular gangrene (red infarction) because the mechanism is venous congestion due to torsion of testis which is an emergency to prevent gangreneSlide17

A tumor in testis…it is well circumscribed and without hemorrhage or necrosis (features that prefer seminoma)Slide18

Rim of the remaining testis

A large lobulated seminomaSlide19

Normal testis remnant

Dense lymphocytic infiltrate

Islands of malignant cells which have large nuclei and clear to pale cytoplasm

SeminomaSlide20

Seminoma

Note the atypia and prominent nucleoliSlide21

SeminomaSlide22

Embryonal carcinoma

Epithelium-like structures that are formed of large cells with prominent

pleomorphism and atypiaSlide23

Cartilagenous

area (part of

teratoma

)

Friable, necrotic and hemorrhagic part (features commonly seen in embryonal carcinoma)

Part of cyst wall (part of cystic

teratoma

)

No normal testicular remnant is seen

Mixed germ cell tumor

(this example is:

teratoma

+ embryonal carcinoma =

teratocarcinoma

…the most common combination)Slide24

Mixed germ cell tumor

(this example is: teratoma + embryonal carcinoma = teratocarcinoma

…the most common combination)

Embryonal carcinoma focus

Cartilage

…part of

teratomaSlide25

Bowen disease of penis

= squamous cell carcinoma in situ…it cannot be differentiated microscopically from Bowenoid papulosis

The

full thickness of epidermis shows markedly enlarged nuclei with pleomorphism, hyperchromasia & prominent nucleoli…+ loss of maturation…BM is intactSlide26

All this is a nucleus…note that this nucleus is very atypical but not necessarily to be hyperchromatic (it has open (white) chromatin pattern)

The

full thickness

of epidermis shows markedly enlarged nuclei with

pleomorphism

& prominent nucleoli…+ loss of maturation…BM is intact

Bowen disease of penisSlide27

Thank You