Prostate cancer diagnosis

Abstract

Prostate cancer is the fourth most common malignancy diagnosed in Missouri. The diagnosis may be clinically suspected based on an elevated serum prostate specific antigen (PSA) and/or digital rectal examination abnormality. Clinical symptoms are usually a manifestation of more advanced disease. The diagnosis is typically established by histopathologic examination of needle biopsy tissue. This article reviews clinical and pathological approaches to prostate cancer diagnosis, with a focus on clinically localized disease and needle biopsy diagnosis.

Figure 1

Adenocarcinoma of the prostate, Gleason grade 3 + 3 = score of 6, in needle core biopsy tissue (H & E stain)

Figure 2

Nuclear atypia in high-grade adenocarcinoma of the prostate, with prominent nucleoli. (H &E stain)

Figure 3

High-grade prostatic adenocarcinoma, Gleason grade 5 +5 = score of 10, with sheet-like growth (left), adjacent to benign prostatic gland (right). (H and E stain)

Figure 4

Small focus of adenocarcinoma with AMACR expression (red stain) surrounded by benign prostatic glands with basal cells present (brown stain)

Figure 5

Gleason grade diagram showing histologic growth patterns of adenocarcinoma. Grade 1 is the most well-differentiated and shows nodule of small glands. Grade 5 is the most poorly-differentiated and shows sheets of carcinoma and/or necrosis, and/or single cancer cells