Preface
Acknowledgments
Contents
About the Authors
1: Anatomy and Normal Histology of the Prostate Pertinent to Biopsy Interpretation
1.1 Anatomy of Normal Prostate
1.2 Anatomy and Disease Preference of Three Zones of the Prostate
1.3 Histology of Normal Prostate
1.4 Immunophenotype of Prostate Glandular Cells
1.5 Histology of Three Zones of Normal Prostate Glands, Other Intraprostatic Structures, and Their Mimics
1.6 Histologic Variations of Normal Prostate Tissue (Also See Chap. 7)
References
2: Needle Biopsy Sampling Techniques and Role of Multiparametric-Magnetic Resonance Imaging Modality in Prostate Cancer Diagnosis and Management
2.1 Comparisons of Three Biopsy Techniques Utilized for Prostate Cancer Detection [2–13]
2.2 Comparisons of Transrectal and Transperineal Biopsy Approach [13–14]
2.3 Multiparametric-Magnetic Resonance Imaging (mp-MRI) for Prostate Cancer Diagnosis and Management [15–19]
References
3: Diagnosis of Limited Cancer in Prostate Biopsy
3.1 General Approach to Prostate Needle Biopsy Evaluation
3.2 Histological Features Considered Specific for and Diagnostic of Cancer
3.3 Major and Minor Diagnostic Features of Prostate Cancer in Biopsy
3.4 Benign Conditions That Cause Architectural and Cytological Atypia
3.5 Quantitative Threshold for Diagnosing Limited Cancer in Biopsy
3.6 Histological Features for and against Cancer Diagnosis in Biopsy
3.7 A Practical Approach to Diagnosis of Limited Cancer in Needle Biopsy
References
4: Immunohistochemistry in Prostate Biopsy Evaluation
4.1 Commonly Used Immunohistochemical Markers for Diagnosis of Prostate Cancer in Biopsy
4.2 Basal Cell Markers
4.3 Αlpha-Methylacyl-CoA-Racemase (AMACR)
4.4 ERG Protein
4.5 Antibody Cocktails
4.6 Differential Diagnosis of Prostate Cancer by Immunohistochemistry
4.7 Immunohistochemical Markers for Prognosis and Risk Stratification
4.8 Practical Guideline for Using Immunohistochemistry in Work-Up of Prostate Biopsies
References
5: Contemporary Approach to Gleason Grading of Prostate Cancer
5.1 Significance of Gleason Grading in Prostate Cancer Management [2–5]
5.2 Prostate Cancer Nomograms and National Comprehensive Cancer Network (NCCN) Recurrence Categories and Prediction Models [5–9]
5.3 The 2005/2014 Modifications of Gleason Grading System [10, 11]
5.4 Contemporary Gleason Pattern 1 [2, 3, 9–16]
5.5 Contemporary Gleason Pattern 2
5.6 Contemporary Gleason Pattern 3
5.7 Common Pitfalls of Pattern 3 (Reasons for Over-interpretation of Pattern 3 as Pattern 4) (See Figs. 5.8, 5.9, 5.10, 5.11, 5.12, 5.13, 5.14, 5.15, 5.16, 5.17, 5.18, 5.19, and 5.20)
5.8 Contemporary Gleason Pattern 4
5.9 Recommendations to Improve Reproducibility of “Poorly Formed” Gleason Pattern 4 [17]
5.10 Common Pitfalls of Pattern 4 (Figs. 5.26, 5.27, and 5.28)
5.11 Contemporary Gleason Pattern 5
5.12 Morphologic Features That Are Associated with High Reproducibility for Gleason Pattern 5 Prostate Cancer (See Figs. 5.33, 5.34, 5.35, and 5.36) [20]
5.13 Gleason Grading of Unusual “Variant” Histology Types and Patterns [11] (Figs. 5.38, 5.39, 5.40, 5.41, 5.42, 5.43, 5.44, 5.45, 5.46, and 5.47)
5.14 New Grading System: Grade Groups [21–24]
5.15 Important Facts About Grade Groups
5.16 Recommendations for Gleason Grading in the Post-therapy Setting
5.16.1 Modified Gleason Grading System: Operational Changes [10, 11]
5.17 Rationale for Reporting Percentage Pattern 4 in Gleason Score 7 Prostate Cancer [3, 11, 29]
5.18 Summary of Current Concepts of Gleason Grading of Prostate Cancer
References
6: Histologic Variants of Acinar Adenocarcinoma, Ductal Adenocarcinoma, Neuroendocrine Tumors, and Other Carcinomas
6.1 The 2016 World Health Organization Classification of Histological Variants of Acinar Adenocarcinoma, Ductal Adenocarcinoma, Neuroendocrine Tumors, and Other Carcinomas [1–2]
6.2 Histologic Variants of Acinar Prostate Carcinoma Mimicking Benign Lesions [1, 3–4]
6.3 Atrophic Adenocarcinoma
6.4 Pseudohyperplastic Carcinoma
6.5 Microcystic Adenocarcinoma [5]
6.6 Foamy Gland Carcinoma
6.7 Mucinous (Colloid) Carcinoma [2, 6–7]
6.8 Signet Ring Cell-Like Carcinoma [2]
6.9 Pleomorphic Giant Cell Carcinoma [8]
6.10 Sarcomatoid Carcinoma (Carcinosarcoma) [2, 9]
6.11 Prostatic Intraepithelial Neoplasia-Like (PIN-Like) Adenocarcinoma [10–12]
6.12 Ductal Adenocarcinoma [2, 12–14]
6.13 The 2016 World Health Organization(WHO) Pathologic Classification and Clinical Significance of Neuroendocrine (NE) Differentiation in Prostate Carcinoma [2, 16–17]
6.14 Small-Cell Neuroendocrine (NE) Carcinoma [2, 7, 17]
6.15 Utility of Immunohistochemistry in Neuroendocrine Tumors of the Prostate
6.16 Urothelial Carcinoma [2, 18–19]
6.17 Squamos and Adenosquamos Cell Carcinoma (SCC) [2]
6.18 Basal Cell Carcinoma (BCC) [2, 20]
References
7: Benign Mimics of Prostate Carcinoma
7.1 Summary of Atypical Morphological Features Commonly Encountered in Various Benign Mimics of Prostate Cancer
7.2 Seminal Vesicle/Ejaculatory Duct Epithelium
7.3 Verumontanum Mucosal Gland Hyperplasia (VMGH)
7.4 Cowper’s Glands
7.5 Mesonephric Remnant Hyperplasia
7.6 Mucinous Metaplasia
7.7 Classification of Focal Atrophy Lesions of the Prostate [12–14]
7.8 Focal Atrophy
7.9 Partial Atrophy [15]
7.10 Postatrophic Hyperplasia (PAH)
7.11 Adenosis (Atypical Adenomatous Hyperplasia)
7.12 Basal Cell Hyperplasia
7.13 Postradiation Atypia in Benign Prostate Glands [17]
7.14 Nephrogenic Adenoma
7.15 Cribriform Proliferations Encountered in the Prostate Gland
7.16 Central Zone Glands
7.17 Clear Cell Cribriform Hyperplasia
7.18 Nonspecific Granulomatous Prostatitis (NSGP)
7.19 Malakoplakia
7.20 Sclerosing Adenosis
7.21 Paraganglia
7.22 Xanthoma
7.23 Benign Mimics of Prostate Cancer: Take-Home Messages
References
8: Intraductal Carcinoma of the Prostate (IDC-P) and Atypical Intraductal Proliferation (AIP)
8.1 Intraductal Carcinoma of the Prostate [1–19]
8.2 Pathologic Features That Are Associated with IDC-P and Helpful to Differentiate from Cribriform HGPIN [16]
References
9: High-Grade Prostatic Intraepithelial Neoplasia
9.1 Histological Features of High-Grade Prostatic Intraepithelial Neoplasia (HGPIN)
9.2 Clinical Significance of HGPIN
9.3 Differential Diagnosis of HGPIN
9.4 Reporting of HGPIN
References
10: Atypical Glands Suspicious for Cancer (ATYP)
10.1 Histological Features Resulting in ATYP
10.2 Working Up Cases with ATYP
10.3 Clinical Significance and Management of ATYP
References
11: Spindle Cell Lesions of the Prostate Gland
11.1 Classification of Spindle Cell Lesions of the Prostate [1–2]
11.2 Specialized Stromal Tumors of the Prostate Gland [1–5]
11.3 Solitary Fibrous Tumor
11.4 Inflammatory Myofibroblastic Tumor
11.5 Leiomyosarcoma
11.6 Immunohistochemical Characteristics of Select Spindle Cell Lesions of Prostate [2, 6–7, 9–10]
References
12: Treatment Effect in Benign and Malignant Prostate Tissue
12.1 Treatment Modalities for Prostate Lesions
12.2 Androgen Pathway and Antiandrogen Therapy in Prostate Cancer
12.3 Histologic Changes Following Androgen Deprivation Therapy in Benign and Malignant Prostate Tissue
12.4 Histological Changes Associated with Radiation Therapy in Benign and Malignant Prostate Tissue
12.5 Histological Changes Associated with Cryotherapy
12.6 Histological Changes Associated with Hyperthermia
References
13: Molecular Biology of Prostate Cancer and Role of Genomic Testing in Diagnosis and Prognosis of Prostate Cancer
13.1 Types of PSA Measurements in Clinical Practice [5]
13.2 Emerging Biomarkers for the Diagnosis and Prognosis of Prostate Cancer [2, 5–16]
13.3 Commercially Available Liquid Biopsy and Other Tissue-Based Platforms (Biomarkers) to Determine When to Perform Prostate Biopsy [18–21]
13.4 Commercially Available Molecular Tests Utilized to Determine Outcome and Therapy Decisions for Prostate Cancer Patients [12, 22–26]
References
14: Biopsy Specimen Handling, Processing, and Quality Assurance Program
14.1 Best Practices for Submission, Handling, and Processing of Prostate Biopsies
14.2 Recommendations for Tissue Submission of Transurethral Prostate Resection Specimens
14.3 Quality Assurance Measures Known to Improve Prostate Biopsy Practice
References
15: Reporting of Prostate Biopsy
15.1 Benign Diagnosis
15.2 HGPIN and ATYP
15.3 Adenocarcinoma of the Prostate
References
16: Pattern-Based Approach to Prostate Biopsy Interpretation
16.1 Morphological Patterns Commonly Seen in Prostate Cancer
16.2 Small Glandular Pattern
16.3 Atrophic Glandular Pattern
16.4 Atypical Large Glandular Lesions
16.5 Cribriform Lesions
16.6 Poorly Formed Glands, Fused Glands, Nests, and Single Cells
16.7 Circumscribed Nodular Proliferation
16.8 Prostate Glands with Pleomorphic Nuclei
16.9 Spindle Cell Lesions
16.10 Neuroendocrine Differentiation and Tumors of the Prostate
Index