33. Prostatic adenocarcinoma

Staining: HE

Overview

Organ: Prostate

Description:

The glands of the healthy, central zone are dilated and normal. The glands of the tumor are smaller, show atypia with very prominent nucleoli and they are not surrounded by basal (myoepithelial-like) cells.

Perineural infiltration, the infiltration of the tumor around peripheral nerve fibres, is present. The nerve fibres are present just beneath and inside the capsule.

Signs of benign prostate hyperplasia are seen in the areas of the slide not affected by the tumor.

Diagnosis: Prostatic adenocarcinoma

Risk factors:

• Old age
• Positive family history
• BRCA mutation
• HPC-1 mutation

Theory:

Benign prostatic hyperplasia mostly affects the transitional zone while cancer mostly affects the peripheral zone.

Perineural invasion, as the tumor cells invade the peripheral nerves.

Those aren’t myoepithelial cells but rather basal cells that just look like myoepithelium. The healthy glands are surrounded by basal cells, whereas the tumor glands aren’t. Also, the cells that comprise the tumor glands have very prominent nucleoli.