Reproductive Pathology II Case Studies


CASE 8: Prostatic adenocarcinoma


Clinical History:

A 76-year-old man noted increased hesitancy with urination over the past few months. His physician palpated a firm nodule in the region of the prostate on physical examination. A urologist biopsied the prostate. His serum prostate specific antigen was 23.8 ng/mL. He underwent a radical prostatectomy.
  1. What is the diagnosis?

    2. What is the diagnosis? This is adenocarcinoma of the prostate. Note how the normal prostatic glands are lined by a tall columnar epithelium and have stroma between the large glands. The neoplastic glands are smaller, more irregular, with cells having a higher N/C ratio and prominent nucleoli.

  2. Who gets this disease?

    3. Carcinoma of the prostate is the most common cancer in men and is the third leading cause of cancer death in men (after lung and colon). It occurs primarily over the age of 50.

  3. How important is histopathologic study of this disease?

    4. Grading of prostate cancers is extremely important because there is a good correlation between the grade and the prognosis.

  4. What is the significance of the laboratory test finding?

    5. Testing for serum prostate specific antigen (PSA) often reveals an elevated level with prostate cancers. The PSA can be slightly elevated with prostatic hyperplasia and with prostatitis. However, PSA levels tend to remain the same over time with benign conditions, while PSA levels increase when an adenocarcinoma is present. The PSA is not generally useful for screening of the population.