DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20172095

Histomorphological spectrum of prostatic lesions: a retrospective analysis of transurethral resection of prostate specimens

Anuja Sharma, Mahima Sharma, Shivani Gandhi, Arvind Khajuria, K. C. Goswami

Abstract


Background: Prostatic diseases like inflammation, benign prostatic hyperplasia and tumors are important causes of mortality and morbidity in males. The incidence of these lesions increases with advancing age. The second most common cancer among males is prostate cancer, next to lung cancer worldwide. Transurethral resection of prostate (TURP) is most frequently preformed surgical procedure in the clinical practice. The purpose of the study is to evaluate histomorphological spectrum of prostate lesions in TURP specimen with focus on premalignant lesions and incidental carcinomas.

Methods: The present study includes 245 cases of TURP specimen from January 2015 to December 2016 received in the post graduate department of pathology, ASCOMS and Hospital. H and E stained sections were examined. The relevant clinical details pertaining to age, clinical complaints and microscopic details were analysed and compared with other similar studies.

Results: Of the total 245 TURP specimen, 223 (91.02%) were of nodular hyperplasia, 14 (5.71%) were of prostatic intraepithelial neoplasia and 8 (3.26%) cases were malignant. Benign hyperplasia of prostate (BHP) alone accounted for 91.02% of TURP specimen. Less frequent findings were granulomatous prostatitis in 3.70% and atypical adenomatous hyperplasia (1.22%). All the 8 cases of prostate cancer were incidental carcinoma, 5 of which were poorly differentiated and 3 were moderately differentiated adenocarcinoma.

Conclusions: The present study showed that non-neoplastic lesions of prostate are more common than neoplastic ones. The most frequently encountered prostatic lesion was BHP, commonly seen in the age group of 61-70 years. The malignant lesions were common among the males of more than 60 years. TURP can be helpful in early identification of premalignant lesions and incidental prostate cancer which can improve the treatment outcome of patients.


Keywords


Incidental prostate carcinoma, Nodular hyperplasia, Prostatitis, PIN, TURP

Full Text:

PDF

References


Shirish C, Jadhav PS, Anwekar SC, Kumar H, Buch AC, Chaudhari US. Clinico-pathological study of benign and malignant lesions of prostate. IJPBS. 2013;3:162-78.

Trpkov K, Thompson J, Kulga A, Yilmaz A. How much tissue sampling is required when unsuspected minimal prostate carcinoma is identified on transurethral resection? Arch Pathol Lab Med. 2008;132:1313-6.

Rosai J. Male reproductive system. In: Rosai J, editor. Rosai and Ackerman’s Surgical Pathology. 10th ed. New Delhi: Elsevier; 2011:1287-1333.

Harik LR, O’Toole KM. Nonneoplastic lesions of the prostate and bladder. Arch Pathol Lab Med. 2012;136:721-34.

Rekhi B, Jaswal TS, Arora B. Premalignant lesions of prostate and their association with nodular hyperplasia and carcinoma prostate. Ind J Cancer. 2004;41:60-5.

Silverio FD, Gentile V, Matteis AD, Mariotti G, Giuseppe V, Luigi PA, et al. Distribution of inflammation, pre-malignant lesions, incidental carcinoma in histologically confirmed benign prostatic hyperplasia: a retrospective analysis. Eu Urol. 2003;43:164-75.

Epstein JI, Lotan TL. The lower urinary tract and male genital system. In: Kumar V, Abbas AK, Aster JC, editors. Robbins and Cotran Pathologic Basis of Disease. 9th ed. New Delhi: Elsevier; 2014:980-990.

Pethiyagoda AUB, Pethiyagoda K. Incidental prostate cancer experience of a tertiary unit in Sri Lanka. IJSRP. 2016;6:246-8.

Otto B, Barbieri C, Lee R, Te AE, Kaplan SA, Robinson B, et al. Incidental prostate cancer in transurethral resection of prostate specimens in the modern era. Adv Urol. 2014:1-4.

Joshee A, Sharma KCL. The histomorphological study of prostate lesions. IOSR-JDMS. 2015;14:85-9.

Burdak P, Joshi N, Nag BP, Jaiswal RM. Prostate biopsies: a five year study at a tertiary care centre. IJSR. 2015;4:420-3.

Thapa N, Shris S, Pokharel N, Tambay YG, Kher YR, Acharya S. Incidence of carcinoma prostate in transurethral resection specimen in a teaching hospital of Nepal. J Lumbini Med Coll. 2016;4:77-9.

Begum Z, Attar AH, Tengli MB, Ahmed MM. Study of various histopathological patterns in Turp specimens and incidental detection of carcinoma prostate. IJPO. 2015;2:303-8.

Josephine A. Clinicopathological study of prostatic biopsies. JCDR. 2014;8:4-6.

Kasliwal N. Pattern of prostatic disease- a histopathological study with clinical correlation. EJPMR. 2016;3:589-97.

Arya RC, Minj MK, Tiwari AK, Bhardwaj A, Singh D, Deshkar AM. Pattern of prostatic lesions in Chhattisgarh Institute of Medical Sciences, Bilaspur: a retrospective tertiary hospital based study. Int J Sci Stud. 2015;3:179-82.

Kumar M, Khatri SL, Saxena V, Vijay S. Clinicopathological study of prostate lesions. IJBAMR. 2016;6:695-704.

Khatib W, Jagtap S, Demde R, Shukla DB, Bisht T. Clinicopathological study of prostate lesions- a one year study. Int J Med Res Health Sci. 2016;5:183-6.

Deshmukh BD, Ramteerthakar NA, Sulhyan KR. Histopathological study of lesions of prostate-a five year study. Int J Health Sci Res. 2014;4:1-9.

Mittal BV, Amin MB, Kinare SG. Spectrum of histological lesions in 185 consecutive prostatic specimens. J Postgrad Med. 1989;35:157.

Puttaswamy K, Parthiban R, Shariff S. Histopathological study of prostatic biopsies in men with prostatism. J Med Sci Health. 2016;2:11-7.

Mathi A, Krishna R, Devi SI. Histological spectrum of non-malignant lesions of prostate. IJSR. 2015;4:192-6.

Hameed O, Humphrey PA. Pseudoneoplastic mimics of prostate and bladder carcinomas. Arch Pathol Lab Med. 2010;134:427-43.

Epstein JI, Netto GJ. Prostate and seminal vesicles. In: Mills SE., editor. Sternberg’s Diagnostic Surgical Pathology.6th ed. Philadelphia: Wolters Kluwer; 2015:2097-2142.

Garg M, Kaur G, Malhotra V, Garg R. Histopathological spectrum of 364 prostatic specimens including immunohistochemistry with special reference to grey zone lesions. Prostate Int. 2013;1:146-51.

Gaudin PB, Sesterhenn IA, Wojno KJ, Mostofi FK, Epstein JI. Incidence and clinical significance of high-grade prostatic intraepithelial neoplasia in TURP specimens. Urol. 1997;49:558-63.

Perera M, Nathan L, Perera N, Bolton D, Clouston D. Incidental prostate cancer in transurethral resection of prostate specimens in men aged up to 65 years. Prostate Int. 2016;4:11-4.