Search

Clinicopathologic data in dogs with prostate cancer (PCa) may aid in the differentiation between tumor types and subsequent treatment decisions; however, these data are often unreported. Demographic, clinicopathologic, cytologic, histologic and survival data from dogs with primary prostatic adenocarcinoma (PRAD) (n = 56) and primary prostatic transitional cell carcinoma (P-TCC) (n = 74) were acquired from a tertiary veterinary teaching hospital from 1992 to 2022. Red blood cell distribution width (RDW) to albumin ratio (RAR) was evaluated for diagnostic utility in differentiating between PRAD and P-TCC. Sections from PRAD tumors (n = 50) were stained for androgen receptor (AR) expression, and laboratory data were compared between AR positive (AR+) and AR negative (AR-) groups. RDW was increased in PRAD, while albumin was decreased (p < 0.05). P-TCC was associated with Melamed-Wolinska bodies (MWB) and necrosis on cytology (p < 0.05). RAR had acceptable diagnostic utility in the differentiation of PCa tumors (AUC = 0.7; p < 0.05). Survival rates and metastases were equivocal. AR+ and AR- PRAD tumors did not differ in clinicopathologic data or survival (p > 0.05). In conclusion, hypoalbuminemia was significantly associated with PRAD and decreased survival, while MWB and necrosis were significantly associated with P-TCC on cytology. These clinicopathologic data may help clinicians differentiate between these tumors ante mortem to guide appropriate treatment and intervention.

Prostatic adenocarcinoma is characterized by elevated phosphatidylcholine metabolism. 18F-choline positron emission tomography/computed tomography (PET/CT) is widely used for patients with biochemical recurrence and a prostate-specific antigen threshold above 2 ng/mL. We report a case of a patient with high-risk prostatic adenocarcinoma undergoing 18F-choline PET/CT for biochemical recurrence. In addition to hypermetabolic abdominal lymph nodes, an unexpected right testicular hypermetabolism was observed. Such findings on 18F-choline PET/CT may suggest a primary tumor or testicular metastasis of prostate cancer. Bilateral orchiectomy revealed a vitelline tumor associated with known primary prostatic cancer. The incidental discovery of a testicular vitelline tumor during prostate cancer imaging is rare, highlighting the importance of thorough diagnostics. This case underscores the need for comprehensive care in managing complex and atypical cancer cases, emphasizing the potential for unrelated tumor discoveries during diagnostic workup. Further research is essential for a better understanding of these rare co-occurring cancers and their treatment implications. [ABSTRACT FROM AUTHOR]

Primary well-differentiated neuroendocrine tumor (WDNT)/carcinoid of the genitourinary tract is rare. Many WDNT reported in the prostate gland have been seen in close association with conventional prostatic adenocarcinoma and/or label for prostate-specific immunohistochemical markers and are best considered prostatic adenocarcinomas with "carcinoid-like" features. We present a case of primary WDNT/carcinoid incidentally detected in a 67-year-old man who underwent radical prostatectomy for Grade group 2 prostatic adenocarcinoma. Morphologically, the neuroendocrine (NE) lesion appeared distinct from the prostatic adenocarcinoma, labeled for NE markers, was negative for prostatic markers (NKX3.1, PSA, and ERG), and showed an overall low Ki-67 proliferation index (<1%). Follow-up was uneventful with no evidence of residual disease or metastasis. [ABSTRACT FROM AUTHOR]

High-grade prostatic intraepithelial neoplasia (HGPIN) is a well-characterised precursor lesion in prostate cancer. The term atypical intraductal proliferations (AIP) describes lesions with features that are far too atypical to be considered HGPIN, yet insufficient to be diagnosed as intraductal carcinoma of the prostate (IDCP). Here, a panel of biomarkers was assessed to provide insights into the biological relationship between IDCP, HGPIN, and AIP and their relevance to current clinicopathological recommendations. Tissue samples from 86 patients with prostate cancer were assessed by routine haematoxylin and eosin staining and immunohistochemistry (IHC) with a biomarker panel (Appl1/Sortilin/Syndecan-1) and a PIN4 cocktail (34βE12+P63/P504S). Appl1 strongly labelled atypical secretory cells, effectively visualising intraductal lesions. Sortilin labelling was moderate-to-strong in > 70% of cases, while Syndecan-1 was moderate-to-strong in micropapillary HGPIN/AIP lesions (83% cases) versus flat/tufting HGPIN (≤ 20% cases). Distinct biomarker labelling patterns for atypical intraductal lesions of the prostate were observed, including early atypical changes (flat/tufting HGPIN) and more advanced atypical changes (micropapillary HGPIN/AIP). Furthermore, the biomarker panel may be used as a tool to overcome the diagnostic uncertainty surrounding AIP by supporting a definitive diagnosis of IDCP for such lesions displaying the same biomarker pattern as cribriform IDCP. [ABSTRACT FROM AUTHOR]

Synchronous prostatic adenocarcinoma found in patients with muscle-invasive bladder cancer (MIBC) that undergo radical cistoprostatectomy is not uncommon. Nonetheless, the occurrence of collision metastasis, where both prostate cancer and bladder cancer involve the same lymph node, is exceptionally uncommon, with few cases being reported in the literature. We present a case of a 65-year-old patient diagnosed with MIBC who underwent laparoscopic radical cistoprostatectomy with extended lymph node dissection and intracorporeal ileal conduit. The final pathology revealed urothelial carcinoma pT3bN1 as well as prostatic adenocarcinoma pT3bN1. One lymph node presented metastasis from both bladder cancer and prostate cancer. [ABSTRACT FROM AUTHOR]

Introduction: Multiple primary malignant neoplasms (MPMNs) are cancers presenting distinct pathological types that originate from different tissues or organs. They are categorized as either synchronous or metachronous. Nowadays, the incidence of MPMN is increasing. Patients and methods: We present a case of a 71-year-old male patient with a medical history of hepatitis B and a family history of breast and endometrial cancers. The patient reported a nasal tip skin lesion with recurrent bleeding, and the history disclosed lower urinary tract symptoms. Further investigations revealed the coexistence of four primary cancers: basosquamous carcinoma of the nasal lesion, prostatic adenocarcinoma, hepatocellular carcinoma, and clear cell renal cell carcinoma. Results: A multidisciplinary team cooperated to decide the proper diagnostic and therapeutic modules. Conclusion: To the best of our knowledge, the synchronization of these four primary cancers has never been reported in the literature. Even so, multiple primary malignant neoplasms, in general, are no longer a rare entity and need proper explanations, a precise representation of definition and incidence, further work-up approaches, and treatment guidelines as well. [ABSTRACT FROM AUTHOR]

Canine prostatic carcinoma (PC) has incompletely defined CT features. The purpose of this multicenter retrospective case series was to assess prostatic, regional, and distant findings of PC. Thirty dogs were enrolled. Consistent prostatic features included postcontrast heterogeneity with hypoattenuating, nonenhancing areas (30/30), capsular distortion (29/30), prostatic urethral effacement, displacement, or invasion (28/30), precontrast heterogeneity (27/30), and mineralization (24/30) which was always within or at the margin of the hypoattenuating areas. Consistent extraprostatic features included medial iliac lymph node enlargement (20/30), internal iliac lymph node enlargement (15/30), and periprostatic fat streaking or fluid (15/29). In a minority of dogs, there was lymph node mineralization, bladder trigone invasion, ureteral dilation, ductus deferens invasion, and bony changes consistent with hypertrophic osteopathy. Strongly suspected and potential bony metastases were noted infrequently (8/26), all in vertebrae regional to the prostate. In conclusion, these findings provide guidance on the expected CT features of canine PC. [ABSTRACT FROM AUTHOR]

Background & Objective: Prostatic adenocarcinoma (PAC) is the second most prevalent cancer and the fifth leading cause of cancer death in men worldwide. Additionally, pathologists may face problems diagnosing it reliably and may need more than one marker. Thus, the search for new immunohistochemical biomarkers becomes mandatory. This study aims to investigate P4HB and SOX4 expression in prostatic carcinoma, their possible roles, and clinical significance. Methods: This retrospective study included fifty-six cases of PAC and an equal number of nodular prostatic hyperplasia (NPH) that were immunohistochemically stained by P4HB and SOX4. The results of expression were compared between PAC and NPH cases, followed by correlations with available clinicopathological parameters. Results: There was a highly significant difference between PAC and NPH regarding P4HB and SOX4 expressions in favor of PAC (both P<0.001). ROC curve analysis of the diagnostic power of P4HB showed 79% sensitivity, 76% specificity, and an area under the ROC curve of 0.845, while SOX4 showed (89%, 100%, and 0.946, respectively). P4HB and SOX4 expression showed a direct correlation (P<0.001). Moreover, the H-score of SOX4 expression showed a significant inverse relation with ERG expression (P=0.047). There was a significant correlation between P4HB and SOX4 and Gleason score (P<0.001). Moreover, P4HB expression was significantly associated with lymphovascular invasion (P=0.013), while SOX4 expression showed a significant association with perineural invasion (P=0.05). Conclusion: SOX4 and P4HB seem to have diagnostic and prognostic value in PAC. While there was a direct correlation between SOX4 and P4HB, an inverse relationship between SOX4 and ERG was detected. [ABSTRACT FROM AUTHOR]

IntroductionMultiple primary malignant neoplasms (MPMNs) are cancers presenting distinct pathological types that originate from different tissues or organs. They are categorized as either synchronous or metachronous. Nowadays, the incidence of MPMN is increasing.Patients and methodsWe present a case of a 71-year-old male patient with a medical history of hepatitis B and a family history of breast and endometrial cancers. The patient reported a nasal tip skin lesion with recurrent bleeding, and the history disclosed lower urinary tract symptoms. Further investigations revealed the coexistence of four primary cancers: basosquamous carcinoma of the nasal lesion, prostatic adenocarcinoma, hepatocellular carcinoma, and clear cell renal cell carcinoma.ResultsA multidisciplinary team cooperated to decide the proper diagnostic and therapeutic modules.ConclusionTo the best of our knowledge, the synchronization of these four primary cancers has never been reported in the literature. Even so, multiple primary malignant neoplasms, in general, are no longer a rare entity and need proper explanations, a precise representation of definition and incidence, further work-up approaches, and treatment guidelines as well.

Aims: The distinction of high‐grade prostate cancer (PCa) from poorly differentiated urothelial carcinoma (UC) can be somewhat challenging on clinical and morphological grounds alone, yet it is of great importance for prognostication and choice of treatment. GATA3 is a useful immunohistochemical marker to confirm urothelial origin. However, recent works report strong GATA3 immunoexpression in primary high‐grade PCa. The aim of this study was to explore GATA3 expression specifically in metastatic PCa. Methods and results: The pathology databases of four tertiary institutions were queried for cases of metastatic PCa. Available slides and clinical records were reviewed by experienced genitourinary pathologists. Prostatic markers (PSA, PSAP, NKX3.1) and GATA3 immunohistochemistry were performed. A total of 163 metastatic PCa cases were included. At least one prostate marker was positive in each case of non‐regional distant metastasis, confirming prostatic origin. GATA3 strong staining was found in four (2.5%) cases: two liver, one bone and one non‐regional lymph‐node metastases. All four patients had Grade Group 5 PCa at the initial diagnosis. The metastatic prostatic adenocarcinomas were solid, either with no gland formation (n = 3) or with only focal cribriforming (n = 1). Conclusions: To our knowledge, this is the first study exploring GATA3 expression specifically in metastatic PCa. Despite being infrequent, GATA3 positivity in high‐grade PCa may lead to misdiagnosis, with clinical implications. We recommend a panel of immunohistochemical markers, both prostatic and urothelial, for ruling out UC, either in primary tumour samples or in the event of metastases of unknown primary, when a genitourinary origin is suspected. [ABSTRACT FROM AUTHOR]

Opinion statement: Localized high-risk (HR) prostate cancer (PCa) is a heterogenous disease state with a wide range of presentations and outcomes. Historically, non-surgical management with radiotherapy and androgen deprivation therapy was the treatment option of choice. However, surgical resection with radical prostatectomy (RP) and pelvic lymph node dissection (PLND) is increasingly utilized as a primary treatment modality for patients with HRPCa. Recent studies have demonstrated that surgery is an equivalent treatment option in select patients with the potential to avoid the side effects from androgen deprivation therapy and radiotherapy combined. Advances in imaging techniques and biomarkers have also improved staging and patient selection for surgical resection. Advances in robotic surgical technology grant surgeons various techniques to perform RP, even in patients with HR disease, which can reduce the morbidity of the procedure without sacrificing oncologic outcomes. Clinical trials are not only being performed to assess the safety and oncologic outcomes of these surgical techniques, but to also evaluate the role of surgical resection as a part of a multimodal treatment plan. Further research is needed to determine the ideal role of surgery to potentially provide a more personalized and tailored treatment plan for patients with localized HR PCa. [ABSTRACT FROM AUTHOR]

Introduction Angiogenesis has been proposed as a promising prognostic marker in a variety of tumours. Microvessel density (MVD) measurement is the most reliable method for the semiquantitative evaluation of angiogenesis. Endoglin (CD105) is a recognised marker of proliferating endothelium and is expressed in intra-tumoral as well as peri-tumoral vessels. It is upregulated in various cancers including prostate cancer, therefore, it is an upcoming prime marker for prognosis, tumour imaging and antiangiogenesis therapy. Aim The study was done to evaluate microvessel density (MVD) by using CD105 (endoglin) as an IHC marker in prostatic adenocarcinoma and to find its relationship with Gleason score and grade groups. Materials and methods This was an observational cross-sectional study under which a total of 31 histopathologically diagnosed cases of prostatic adenocarcinoma on TURP chips were included and were graded according to Gleason score and grades.IHC using endoglin (CD105) was done to detect the highest-density areas of stained vessels (hot spots). The highest value obtained in three hot spot fields was reported as microvessel density (MVD) and its relationship with Gleason score and grade groups was analysed. Results Most common age group was 71-80 years (48.39% cases). Maximum cases (45.16%) had a Gleason score of 9. The maximum mean MVD CD105 score was found in the Gleason grade group 5 (45.32%) while the minimum was in grade group 1 (24%). Comparison of mean MVD CD105 scores in different Gleason grade groups revealed a significant association of MVD CD105 with Gleason grade groups. Conclusion Endoglin measures microvessel density and its expression correlated with Gleason score and grade group. Hence it can be used as a potential prognostic marker in adenocarcinoma prostate.

Synchronous prostatic adenocarcinoma found in patients with muscle-invasive bladder cancer (MIBC) that undergo radical cistoprostatectomy is not uncommon. Nonetheless, the occurrence of collision metastasis, where both prostate cancer and bladder cancer involve the same lymph node, is exceptionally uncommon, with few cases being reported in the literature. We present a case of a 65-year-old patient diagnosed with MIBC who underwent laparoscopic radical cistoprostatectomy with extended lymph node dissection and intracorporeal ileal conduit. The final pathology revealed urothelial carcinoma pT3bN1 as well as prostatic adenocarcinoma pT3bN1. One lymph node presented metastasis from both bladder cancer and prostate cancer.

Background: Claudins are a clan of proteins that are the most important component of tight junctions. The claudin-4 expression has been linked to tumour cell invasion and progression in a variety of primary malignancies. Evaluation of lymphovascular density (LVD) correlates with tumour aggressiveness and may correlate with prognosis. D2-40 is a highly specific marker of lymphatic vessels. Aims: To evaluate the claudin-4 expression in relation to LVD by D2-40 expression and with clinicopathological parameters in prostatic adenocarcinoma. Settings and Design: Prospective study Materials and Methods: 39 cases of prostatic adenocarcinoma were taken, the D2-40 and claudin-4 immunohistochemical stains were performed and correlation was done with clinicopathological parameters. Statistical Analysis Used: Statistical analyses such as mean, median, standard deviation, Mann–Whitney U test, Fischer exact test, Spearman's rank-order correlation coefficient, Chi-square test and T-test were used. Results: The claudin-4 expression was seen higher in cases with higher Gleason score but it was statistically non-significant (P = 0.778). The claudin-4 expression did not correlate with any clinicopathological parameters. LVD in the peritumoral area was significantly higher as compared to the intratumoral area (P = 0.005). Intratumoral LVD and perineural invasion were found to be statistically significant (P = 0.048). Conclusion: The claudin-4 expression may correlate with adverse prognostic parameters. Higher lymphatic vessels can be responsible for the higher metastatic potential of prostatic adenocarcinomas. [ABSTRACT FROM AUTHOR]

Background : Prostatic adenocarcinoma is the most common cancer in men and the second leading cause of death after lung cancer in many countries around the world,and accounts for about 20% of all cancers in men in the United States. In prostatic cells CD 10 acts as a transmembrane peptidase .It plays an important role in the pathogenesis of prostatic cancer. Generally it cleaves the excessive growth factor from the stroma thereby it prevents the continuous and unwanted growth in the luminal epithelial cells. Aim and objectives: To determine percentage of the expression of CD 10 in the prostate Adenocarcinoma and to analyse the pattern of expression (membranous, cytoplasm, both) and correlate the expression of CD10 with histopathological gleason score grading. Methodology: Hospital based observational study was conducted in Department of Pathology,Dr. S.N. Medical College, Jodhpur on Paraffin block of cases that fulfilled the inclusion criteria will be selected along with the permission to review the requisition form of these blocks biopsy specimen. Patient name, age, gender, registration number, path number, type of biopsy specimen and its gross feature will be noted. Issued blocks will be cut serially at 3 to 5-micron thickness using rotatory microtome to prepare slides. Slides will be stained with routine hematoxylin and eosin stain and then mounted with DPX to review, after confirming and noting the diagnosis and microscopy details. We analysed 5 cases Benign prostatic hyperplasia, 5 cases Prostatic intraepithelial neoplasia, 70 cases Prostatic adenocarcinoma The correlation between CD10 and various clinico pathological parameters were analysed. RESULTS : A total of 80 cases were studied for CD10 expression which included Benign prostatic hyperplasia shows Apical membranous positivity, decreased membranous expression in high grade PIN, and altered expression in prostatic carcinoma. In prostatic carcinoma none of the cases of Grade Group I and II showed cytoplasmic positivity. The 16.66% of cases of Grade Group III, 54.54% of cases of Grade Group IV and 72.22% of cases of Grade Group V showed cytoplasmic expression. Conclusion : As the Gleason Score/Grade Group increased the pattern of expression changed from membranous to cytoplasmic to both types of expression. Still the exact mechanism and the role of CD10 in the pathogenesis of prostatic carcinoma is under study, In future this marker could be used as a diagnostic marker in differentiating benign and malignant lesions, to categorise the low grade and high grade tumors, and to determine the aggressive nature of the neoplasm. [ABSTRACT FROM AUTHOR]

Background:Prostatic lesions account for the major afflictions in the geriatric population worldwide. Prostate specific antigen can be used for screening but histopathology remains the gold standard for differentiating benign and malignant prostatic enlargements and definite diagnosis. Furthermore, a precise pathologic evaluation of the prostatectomy specimen can provide additional prognostic factors including pathological stages and surgical margin status. Methods: A systematic search identified 306 prostatic specimens submitted in the department over a time period of three years (January 2019-December 2021). Relevant clinical data, PSA level and H&E stained sections were examined for microscopic details and diagnosis. Results: Benign Prostate Hypertrophy (BHP) was the most common prostatic lesion and accounted for 83% of all cases. The age range was 49 to 90 years with a peak age group between 6th-7th decade. BPH associated with prostatitis and basal cell hyperplasia was seen in 57.8% and 3.3% cases respectively. A single case of non-specific granulomatous prostatitis was seen. Malignant tumours constituted 15.7% of all prostatic specimen. Adenocarcinoma was the histopathological subtype in all primary tumours. A single case of metastatic deposits from bladder tumour was recorded. Gleason score 7 was the most frequent (38.2.8%) in occurrence. Most adenocarcinomas were moderately differentiated (55.3%). Prostate Intraepithelial neoplasia (pre malignant lesion) was seen in 1.3 % of cases. Conclusion: Benign Prostate lesions occur more frequently when compared to malignant ones. Major proportion of benign lesions was contributed by Benign prostate hypertrophy. A pathologist's awareness of the benign mimics is important for the diagnosis of Prostate carcinoma. [ABSTRACT FROM AUTHOR]

Background: Prostatic lesions account for the major afflictions in the geriatric population worldwide. Prostate specific antigen can be used for screening but histopathology remains the gold standard for differentiating benign and malignant prostatic enlargements and definite diagnosis. Furthermore, a precise pathologic evaluation of the prostatectomy specimen can provide additional prognostic factors including pathological stages and surgical margin status. Methods: A systematic search identified 306 prostatic specimens submitted in the department over a time period of three years (January 2019-December 2021). Relevant clinical data, PSA level and H&E-stained sections were examined for microscopic details and diagnosis. Results: Benign Prostate Hypertrophy (BHP) was the most common prostatic lesion and accounted for 83% of all cases. The age range was 49 to 90 years with a peak age group between 6th-7th decade. BPH associated with prostatitis and basal cell hyperplasia was seen in 57.8% and 3.3% cases respectively. A single case of non-specific granulomatous prostatitis was seen. Malignant tumours constituted 15.7% of all prostatic specimen. Adenocarcinoma was the histopathological subtype in all primary tumours. A single case of metastatic deposits from bladder tumour was recorded. Gleason score 7 was the most frequent (38.2.8%) in occurrence. Most adenocarcinomas were moderately differentiated (55.3%). Prostate Intraepithelial neoplasia (pre malignant lesion) was seen in 1.3 % of cases. Conclusion: Benign Prostate lesions occur more frequently when compared to malignant ones. Major proportion of benign lesions was contributed by Benign prostate hypertrophy. A pathologist's awareness of the benign mimics is important for the diagnosis of Prostate carcinoma.

Metastatic tumors in the oral cavity are rare, accounting for only 1% of all oral malignancies. The most common site of metastatic tumors in the oral cavity is the mandibular molar region. The primary sites differ between the sexes. Among men, the primary sites are the lung, kidney, liver, and prostate in the order of frequency. Moreover, 11% of jawbone metastases among men originate from the prostate gland. Symptoms differ according to the location of the metastasis; besides, metastases-related imaging findings are nonspecific, making it difficult to reach an accurate diagnosis. Metastatic oral cancer has a poor prognosis; therefore, early diagnosis and treatment are important to improve the survival-rate and quality of life. A 76-year-old male patient was referred to our hospital with complaint of right-sided mandibular swelling and past medical history of adenocarcinoma of the prostate gland. Intraoral examination revealed a hard hemispherical mass on the right mandibular first molar region. Computed tomography showed a well-marginated radiopaque hemisphere mass with a typical sunburst periosteal reaction. Based on the imaging findings, we suspected primary osteosarcoma or metastatic prostate cancer. Histopathological examination of the mandible revealed a glandular structure with atypia similar to that of the primary prostate cancer cells. After prostate specific antigen monitoring therapy, the metastatic cancer did not grow. Metastatic cancers from other organs should be considered in the differential diagnosis of jawbone malignancies because the metastatic cancer might present similarities to the primary cancer in imaging findings, as in the present case that clinically mimicked osteosarcoma. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer (PCa) is one of the most common cancer in men globally. Prostate-specific antigen (PSA) is used for screening and biopsy is used to confirm the diagnosis. Inflammatory markers serve as non-invasive predictors of PCa. Thus, this study was performed to evaluate the role of PSA, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and red cell distribution width (RDW) in predicting PCa. Materials and Methods: This was a retrospective, observational study carried out at a tertiary care hospital for a period of two years and eight months from Oct 2019 to June 2022. It included the biopsy samples of all the male patients who underwent the transrectal ultrasound guided prostate biopsy. The samples were evaluated by the histopathology section of the pathology department. In the patients suffering from confirmed prostatic carcinoma (PCa), the levels of PSA, lymphocyte, neutrophil and platelet counts before the biopsy were noted. Gleason scores were graded. NLR, PLR and RDW were evaluated. Among the non-PCa, the samples were categorized into two groups based on histological results -- Prostatitis and Benign prostatic hyperplasia (BPH). Unpaired t-test and Mann Whitney U test were used as test of significance. P value < 0.05 was considered significant. Results: Total 73 biopsy samples were evaluated. The average age of the patients was 66.48 ± 5.8 years. 55 out of 73 were non-PCa and 16 were classified as prostatic adenocarcinoma. All of the 55 non-PCa patients were classified as benign prostatic hypertrophy. PSA values were significantly higher in PCa as compared toBPH patients (p< 0.001). There was no statistically significant difference in the median NLR, PLR and RDW in the BPH and PCa group. Majority (37.5%, n =6) patients were categorised into grade 3 Gleason score followed by 5 (31.25%) patients in grade 4. Also, the correlation between Gleason score and PSA, NLR, PLR and RDW was statistically insignificant in PCa patients. Conclusion: Significantly high PSA levels are seen in PCa but it is not specific for PCa. Inflammatory markers NLR, PLR, RDW does not serve as reliable indicators for diagnosis of PCa. [ABSTRACT FROM AUTHOR]

Background & Objective: Prostatic adenocarcinoma (PAC) is one of the most common tumors worldwide. Immunohistochemical expression of cytokeratins has been evaluated in the diagnosis and prognosis of tumors. The aim of the present study is the evaluation of Cytokeratin-7 (Ck-7) and Cytokeratin-19 (Ck-19) expression and its relationship with Gleason score in patients with PAC. Methods: In this cross-sectional study, 78 samples from 78 patients with PAC referred to Mostafa Khomeini Hospital were gathered. Samples were immunohistochemically stained by Ck-7 and Ck-19 markers. The percentage of each marker in tumor cells was determined, and its relationship with Gleason scores and Gleason grade groups was analysed by SPSS version 24. Results: The expression of Ck-7 and Ck-19 were seen in 37.2% and 82.1% of samples, respectively. The mean of Ck-7 expression in tumor cells was 4.98%±7.19 (ranged 0 to 26%), while the mean of Ck-19 expression was 41.02%±23.36 (ranged 0 to 78%). There was no relationship between Ck-7 expression with Gleason scores and Gleason grade groups. However, Ck-19 expression was increased in higher Gleason scores and Gleason grade groups (P<0.001). No relationship was found between age and Ck-7 (P=0.309) and Ck-19 (P=0.375). Conclusion: The Ck-7 expression in PAC samples is weak and focal and had no relationship with the Gleason scores and Gleason grade groups. However, Ck-19 expression in PAC was high and was associated with tumor dedifferentiation of samples. There was no relationship between the expression of both markers with the patient's age. [ABSTRACT FROM AUTHOR]

Tissue changes and the enlargement of the prostate, whether benign or malignant, are among the most common groups of diseases that affect men and can have significant impacts on length and quality of life. The prevalence of benign prostatic hyperplasia (BPH) increases significantly with age and affects nearly all men as they grow older. Other than skin cancers, prostate cancer is the most common cancer among men in the United States. Imaging is an essential component in the diagnosis and management of these conditions. Multiple modalities are available for prostate imaging, including several novel imaging modalities that have changed the landscape of prostate imaging in recent years. This review will cover the data relating to commonly used standard-of-care prostate imaging modalities, advances in newer technologies, and newer standards that impact prostate gland imaging. [ABSTRACT FROM AUTHOR]

Despite significant therapeutic advances, metastatic CRPC (mCRPC) remains a lethal disease. Mutations in homologous recombination repair (HRR) genes are frequent in mCRPC, and tumors harboring these mutations are known to be sensitive to PARP inhibitors. The aim of this study was to verify the technical effectiveness of this panel in the analysis of mCRPC, the frequency and type of mutations in the BRCA1/BRCA2 genes, as well as in the homologous recombination repair (HRR) genes. A total of 50 mCRPC cases were analyzed using a multi-gene next-generation sequencing panel evaluating a total of 1360 amplicons in 24 HRR genes. Of the 50 cases, 23 specimens (46.0%) had an mCRPC harboring a pathogenic variant or a variant of uncertain significance (VUS), whereas in 27 mCRPCs (54.0%), no mutations were detected (wild-type tumors). BRCA2 was the most commonly mutated gene (14.0% of samples), followed by ATM (12.0%), and BRCA1 (6.0%). In conclusion, we have set up an NGS multi-gene panel that is capable of analyzing BRCA1/BRCA2 and HRR alterations in mCRPC. Moreover, our clinical algorithm is currently being used in clinical practice for the management of patients with mCRPC. [ABSTRACT FROM AUTHOR]

Clinicopathologic data in dogs with prostate cancer (PCa) may aid in the differentiation between tumor types and subsequent treatment decisions; however, these data are often unreported. Demographic, clinicopathologic, cytologic, histologic and survival data from dogs with primary prostatic adenocarcinoma (PRAD) (n = 56) and primary prostatic transitional cell carcinoma (P-TCC) (n = 74) were acquired from a tertiary veterinary teaching hospital from 1992 to 2022. Red blood cell distribution width (RDW) to albumin ratio (RAR) was evaluated for diagnostic utility in differentiating between PRAD and P-TCC. Sections from PRAD tumors (n = 50) were stained for androgen receptor (AR) expression, and laboratory data were compared between AR positive (AR+) and AR negative (AR−) groups. RDW was increased in PRAD, while albumin was decreased (p < 0.05). P-TCC was associated with Melamed-Wolinska bodies (MWB) and necrosis on cytology (p < 0.05). RAR had acceptable diagnostic utility in the differentiation of PCa tumors (AUC = 0.7; p < 0.05). Survival rates and metastases were equivocal. AR+ and AR− PRAD tumors did not differ in clinicopathologic data or survival (p > 0.05). In conclusion, hypoalbuminemia was significantly associated with PRAD and decreased survival, while MWB and necrosis were significantly associated with P-TCC on cytology. These clinicopathologic data may help clinicians differentiate between these tumors ante mortem to guide appropriate treatment and intervention.

Background:In recent years, anatomic pathology laboratories have been struck by new revenue policies secondary to the Affordable Care Act. In particular, modifications to compensation for processing prostatic core needle biopsies (PCNBs) have led to important reimbursement cuts. Herein, we explore a hypothetical reduction in the costs for the processing of PCNBs using three simple, hypothetical methods while maintaining high-standard patient care. Materials and methods:We determined the number of blocks and slides used per case on all PCNBs performed at our institution from August 2013 to September 2014 and calculated the total procedural cost for each case and for the total number of cases processed during the study period based on a published estimated procedural cost. We then estimated the procedural cost of three different proposed hypothetical scenarios that consisted in reducing the number of blocks used per case. A Student t test was used to assess the difference between real and hypothetical costs. Results:A total of 4,406 paraffin blocks were used to process 363 PCNBs with a total annual procedural cost of $26,303. By implementing any of the hypothetical scenarios, the annual procedural cost was significantly reduced; the reduction could potentially be as low as $8,978 (P

Aims: The aims are to study the utility of GATA-3 along with panel of immunohistochemical (IHC) markers in the differential diagnosis of primary and metastatic poorly differentiated urothelial carcinoma (UC). Settings and Design: This is a prospective and retrospective observational study. Subjects and Methods: Poorly differentiated carcinomas of urinary tract and metastatic sites from January 2016 to December 2017 were subjected to a panel of four IHC markers including GATA-3, p63, Cytokeratin (CK) 7, and CK20. Additional markers such as p16, an enzyme called alpha-methylacyl-CoA racemase, CDX2, and thyroid transcription factor 1 were also done depending on the morphology and site. Statistical Analysis Used: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of GATA-3 in making the diagnosis of UC were calculated. Results: Forty-five cases were included in the study and after appropriate IHC, the diagnosis was resolved as UC in 24 cases. GATA-3 was positive in 83.33% of UC; all the four markers positive in 33.33% and all negative in 4.17% of UC. However, at least one of the four markers was present in 95.83% of UC, except in sarcomatoid UC. GATA-3 had 100% specificity in differentiating from prostate adenocarcinoma. Conclusion: GATA-3 is a useful marker in the diagnosis of UC in the primary and metastatic sites with a sensitivity of 83.33%. GATA-3 along with other IHC markers in correlation with clinical and imageological features is necessary for making specific diagnosis of poorly differentiated carcinoma. [ABSTRACT FROM AUTHOR]

This report delineates an intriguing example of advanced prostatic adenocarcinoma displaying distinctive histopathological characteristics associated with a KIAA1549::BRAF fusion, a genomic anomaly predominantly identified in central nervous system tumors. A 66-year-old man, presenting with acute renal failure, exhibited metastatic disease involving pelvic soft tissue, bladder, liver, and bone. Histological examination revealed a markedly unconventional morphology within the prostate, characterized by infiltrative tumor sheets exhibiting abundant vacuolated cytoplasm, hyperchromatic nuclei, and irregular nuclear membranes, distinct from typical prostatic adenocarcinoma. Immunophenotyping confirmed NKX3.1 positivity and GATA3 negativity. Molecular analysis revealed the rare KIAA1549::BRAF fusion alongside pertinent mutations in phosphatidylinositol 3-kinase, phosphatase and tensin homolog, and tumor protein 53 genes. Despite diverse therapeutic interventions targeting mitogen-activated protein kinase signaling and subsequent clinical trial enrollment, disease progression remained relentless, culminating in the patient's demise within 4 years of diagnosis. This report highlights the exceptional histopathological presentation associated with KIAA1549::BRAF fusion in prostatic adenocarcinoma, emphasizing the need for a deeper comprehension of its implications on disease behavior and therapeutic responsiveness in similar instances. [ABSTRACT FROM AUTHOR]

Context: Though mast cells infiltrate solid tumors, the exact role of mast cells in tumor biology is controversial. Mast cell density (MCD) may vary depending on its location in the tumor and tumor vascularity. MCD may influence the tumor aggressiveness. Aims: This study evaluates MCD and tumor vascularity in different histopathological grades of adenocarcinoma prostate. Settings and Design: Descriptive study with purposive sampling. Methods and Material: The subjects of study were 42 adenocarcinoma patients. 20 cases were of intermediate grade (Gleason score 2–7) and 22 were of high-grade (Gleason score 8-10). Histological diagnosis was made by examining sections stained with hematoxylin and eosin. Additional sections from the same block were stained for mast cells using Giemsa stains as per standard protocol. Mast cell count was done in minimum six random high-power microscopy fields in four different regions- intratumoral, peritumoral, stromal and perivascular regions. Statistical Analysis Used: SSPS software version 13.0. Descriptive statistics, Student's t test and ANOVA test. Results: In high-grade adenocarcinoma, mast cell counts were higher in perilesional, stromal and perivascular regions, whereas it was lower in intralesional areas as compared to the intermediate grade. However, statistical significance was observed only for the perivascular region. There was significantly higher number of blood vessels in high-grade adenocarcinoma as compared to intermediate grade adenocarcinoma. Conclusions: In this study, perilesional mast cells and vascularity increased with increased severity of adenocarcinoma. These findings suggest a possible influence of mast cells on the tumor microenvironment such as vessel density and aggressiveness of tumor. However, further studies are required to substantiate results of this study.

In prostate adenocarcinoma, both tumorous stroma and epithelium have important role in tumor progression. Transforming growth factor beta (TGF- β) is a promotor in advanced stages of prostate cancer. Matrix Metalloproteinase 2 (MMP2), the endopeptidase that degrades extracellular matrix is considered to be overexpressed in prostatic carcinoma related to its growth and aggressiveness. Therefore, the aim was to analyze the expression of proteins TGF- β and MMP2 between both epithelium and stroma of prostatic adenocarcinoma and adjacent unaffected parenchyma. The intensity of TGF- β and MMP2 expression in epithelium, tumorous stroma and adjacent unaffected parenchyma was analyzed in 62 specimens of prostatic adenocarcinoma by microarray-based immunohistochemistry. TGF- β was more expressed in tumorous than in prostate stroma (p =0.000), while no statistical significance in case of MMP2 (p = 0.097) was found. MMP2 was more expressed in tumorous than in prostate epithelium (p =0.000), while no statistical significance in case of TGF- β (p = 0.096) was observed. The study results indicate that both tumorous stroma and epithelium have a role in tumor progression and support potential role of TGF- β and MMP2 in prostatic adenocarcinoma progression.

Abstract Background Prostatic cancer is uncommon in dogs. Dogs with prostatic carcinoma have been reported to have a poor prognosis. Information regarding prognosis with various surgery options as well as prognosis with surgical vs. medical treatment is lacking. This retrospective study compares the outcomes of medical management to surgical treatment in dogs with prostatic adenocarcinoma and assesses the surgical outcomes of patients who underwent total prostatectomy (TP) and prostatocystectomy (TPC). The medical records of 41 dogs with prostatic adenocarcinoma, between February 2008 and June 2019, were reviewed for information on signalment, clinical signs in the initial evaluation, preoperative diagnostic imaging findings, treatment type (non-surgical or surgical), surgery type, postoperative complications, adjunctive medical therapy, and survival time. The dogs were divided into non-surgical (n = 12) or surgical (n = 29) groups. The surgical group was subdivided into the TP (n = 20) and TPC (n = 9) subgroups. Results Age was not significantly different between the surgical (median 13.1 years [8.4–15.4] years) and the non-surgical groups (median 10.8 [7.7–15.3] years). Body weight (BW) was also not significantly different between the surgical (median 6.8 kg [2.4–34.5 kg]) and non-surgical groups (median 6.4 kg [3.7–9.12 kg]). The overall median survival time (MST) from the initial evaluation was significantly longer in the surgical than in the non-surgical group (337 vs. 90.5 days). The postoperative MST was significantly longer in the TP group than in the TPC subgroup (510 vs. 83 days). As TPC was performed in cases of tumor progression, its postoperative complications were severe, resulting in a shorter MST. Ten (50%) and 6 patients (30%) in the TP subgroup postoperatively showed mild and severe urinary incontinence, respectively, whereas all patients in TPC subgroup did show severe incontinence. Conclusion Results of the study suggest that surgical treatment of prostatic carcinoma results in longer survival times over medical management alone. In particular, TP might be recommended for improving survival time and quality of life in canine prostatic adenocarcinoma that does not infiltrate the bladder. Early detection is key for a survival advantage with surgical treatment.

Prostatic adenocarcinomas with large cribriform glands/intraductal carcinoma (LC/IDC), or the recently proposed unfavorable histology, are associated with adverse outcomes after radical prostatectomy. However, Gleason pattern 4 carcinomas without LC/IDC (or unfavorable histology) have minimal risk for aggressive clinical behavior after prostatectomy. As proof-of-principle study, we collected a cohort of 485 radical prostatectomy specimens to assess correlations between different subtypes of Gleason pattern 4 disease and the presence of adjacent high-risk prostatic adenocarcinoma, defined as LC/IDC or unfavorable histology. All prostatectomies were completely embedded, and all slides re-reviewed to record Gleason score/Grade Group, diameter of the largest cribriform gland (i.e. the longest cross-sectional distance), and all architectural patterns of carcinoma utilizing previously described Canary methodology. The presence and percent of LC/IDC (defined as >0.25 mm) was determined. We also evaluated correlation with the recently proposed "unfavorable histology" as a secondary endpoint. Complex Gleason pattern 4 subtypes, distinct from LC/IDC and unfavorable histology, were termed "borderline histology" and defined as the presence of any of the following patterns: small cribriform/glomeruloid architecture (≤0.25 mm), dominant population of poorly formed glands/small nests, simple glomerulations, and epithelial complexity associated with extravasated mucin (beyond typical mucinous fibroplasia pattern and not containing cribriform >0.25 mm). Comparisons between recorded variables and LC/IDC (or unfavorable histology) utilized the Wilcoxon test for continuous variables and chi-squared test or Fisher's test for categorical variables. Pearson or phi correlation coefficients were used to assess the association between two variables. "Borderline histology" was significantly correlated to LC/IDC (r = 0.55) and unfavorable histology (r = 0.607), both p < 0.001. Specifically, small cribriform/small glomeruloid architecture had the strongest correlation, compared to the other "borderline histology" subtypes (r = 0.646). We demonstrate that "borderline histology" has a strong association with the concomitant presence of high-risk prostate cancer by current histologic definitions (i.e. LC/IDC and unfavorable histology). This proof-of-principle study suggests that large cohort biopsy-RP correlation studies are needed, as the presence of these patterns on biopsy could potentially aid preoperative risk stratification for patients without other high-risk features at initial evaluation., Competing Interests: Declaration of competing interest The authors have no financial or personal interests to disclose., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: To determine if single-port robotic-assisted radical prostatectomy (SP-RARP) has higher rates of incisional hernias when compared with multi-port robotic-assisted radical prostatectomies (MP-RARP). Materials and Methods: A retrospective, single-institution review of all consecutive robotic prostatectomy cases between January 2017 and December 2022. Analyzed multi-port and single-port robotic prostatectomies performed by two high-volume surgeons. Measured primary outcome for the development of incisional hernias, as defined by computed tomography imaging and clinical documentation. Multivariable logistic regression was used to determine the effect of the single-port approach on incisional hernia outcomes. Results: A total of 493 patients were included in the study (320 SP-RARPs and 173 MP-RARPs). The overall incisional hernia rate was 8.5% (SP-RARP 8.1% vs MP-RARP 9.2%, p = 0.669). A median follow-up time was 16.6 months and a median time from procedure to hernia diagnosis was 7.4 months. SP-RARP had shorter OR time than the MP-RARP (236 minutes vs 276 minutes, p < 0.001). Patients who developed hernias had higher body mass index (BMIs) than those who did not (30.7 vs 29, p = 0.009). Multivariable logistic regression analysis revealed that patients with higher BMI (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.14) and a history of prior operation (OR 2.23, 95% CI 1.71-4.29) were more likely to develop incisional hernias. Cox regression analysis accounting for the difference in follow-up period demonstrated that SP-RARP 3.4× more likely to develop incisional hernias than MP-RARP (hazard ratio 3.38, 95% CI 1.50-7.58). Conclusions: Patients with higher BMIs and prior history of abdominal surgeries are at increased risk of developing postoperative incisional hernias. SP-RARP procedures confer a higher risk of postoperative incisional hernias.

Prostatic adenocarcinoma is characterized by elevated phosphatidylcholine metabolism. 18 F-choline positron emission tomography/computed tomography (PET/CT) is widely used for patients with biochemical recurrence and a prostate-specific antigen threshold above 2 ng/mL. We report a case of a patient with high-risk prostatic adenocarcinoma undergoing 18 F-choline PET/CT for biochemical recurrence. In addition to hypermetabolic abdominal lymph nodes, an unexpected right testicular hypermetabolism was observed. Such findings on 18 F-choline PET/CT may suggest a primary tumor or testicular metastasis of prostate cancer. Bilateral orchiectomy revealed a vitelline tumor associated with known primary prostatic cancer. The incidental discovery of a testicular vitelline tumor during prostate cancer imaging is rare, highlighting the importance of thorough diagnostics. This case underscores the need for comprehensive care in managing complex and atypical cancer cases, emphasizing the potential for unrelated tumor discoveries during diagnostic workup. Further research is essential for a better understanding of these rare co-occurring cancers and their treatment implications., Competing Interests: Conflict of Interest: No conflicts of interest were declared by the authors., (Copyright© 2024 The Author. Published by Galenos Publishing House on behalf of the Turkish Society of Nuclear Medicine.)

High-grade prostatic intraepithelial neoplasia (HGPIN) is a well-characterised precursor lesion in prostate cancer. The term atypical intraductal proliferations (AIP) describes lesions with features that are far too atypical to be considered HGPIN, yet insufficient to be diagnosed as intraductal carcinoma of the prostate (IDCP). Here, a panel of biomarkers was assessed to provide insights into the biological relationship between IDCP, HGPIN, and AIP and their relevance to current clinicopathological recommendations. Tissue samples from 86 patients with prostate cancer were assessed by routine haematoxylin and eosin staining and immunohistochemistry (IHC) with a biomarker panel (Appl1/Sortilin/Syndecan-1) and a PIN4 cocktail (34βE12+P63/P504S). Appl1 strongly labelled atypical secretory cells, effectively visualising intraductal lesions. Sortilin labelling was moderate-to-strong in > 70% of cases, while Syndecan-1 was moderate-to-strong in micropapillary HGPIN/AIP lesions (83% cases) versus flat/tufting HGPIN (≤ 20% cases). Distinct biomarker labelling patterns for atypical intraductal lesions of the prostate were observed, including early atypical changes (flat/tufting HGPIN) and more advanced atypical changes (micropapillary HGPIN/AIP). Furthermore, the biomarker panel may be used as a tool to overcome the diagnostic uncertainty surrounding AIP by supporting a definitive diagnosis of IDCP for such lesions displaying the same biomarker pattern as cribriform IDCP., (© 2023. The Author(s).)

Background: Most Prostate Imaging-Reporting and Data System (PI-RADS) 3 lesions do not contain clinically significant prostate cancer (CSPCa; grade group ≥2). This study was aimed at identifying clinical and magnetic resonance imaging (MRI)-derived risk fac- tors that predict CSPCa in men with PI-RADS 3 lesions.Methods: This study analyzed the detection of CSPCa in men who underwent MRI-targeted biopsy for PI-RADS 3 lesions. Multivariable logistic regression models with goodness-of-fit testing were used to identify variables associated with CSPCa. Receiver operating curves and decision curve analyses were used to estimate the clinical utility of a predictive model.Results: Of the 1784 men reviewed, 1537 were included in the training cohort, and 247 were included in the validation cohort. The 309 men with CSPCa (17.3%) were older, had a higher prostate-specific antigen (PSA) density, and had a greater likelihood of an anteriorly located lesion than men without CSPCa (p < .01). Multivariable analysis revealed that PSA density (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.05-1.85; p < .01), age (OR, 1.05; 95% CI, 1.02-1.07; p < .01), and a biopsy-naive status (OR, 1.83; 95% CI, 1.38-2.44) were independently associated with CSPCa. A prior negative biopsy was negatively associated (OR, 0.35; 95% CI, 0.24-0.50; p < .01). The application of the model to the validation cohort resulted in an area under the curve of 0.78. A predicted risk threshold of 12% could have prevented 25% of biopsies while detecting almost 95% of CSPCas with a sensitivity of 94% and a specificity of 34%.Conclusions: For PI-RADS 3 lesions, an elevated PSA density, older age, and a biopsy-naive status were associated with CSPCa, whereas a prior negative biopsy was negatively associated. A predictive model could prevent PI-RADS 3 biopsies while missing few CSPCas.Lay Summary: Among men with an equivocal lesion (Prostate Imaging-Reporting and Data System 3) on multiparametric magnetic resonance imaging (mpMRI), those who are older, those who have a higher prostate-specific antigen density, and those who have never had a biopsy before are at higher risk for having clinically significant prostate cancer (CSPCa) on subsequent biopsy. However, men with at least one negative biopsy have a lower risk of CSPCa. A new predictive model can greatly reduce the need to biopsy equivocal lesions noted on mpMRI while missing only a few cases of CSPCa. [ABSTRACT FROM AUTHOR]

Simple Summary: The present paper describes a rare case of hypertrophic osteopathy in a castrated dog with prostatic cancer and multiple metastases (lymph nodes, liver, spleen, bones and lungs). Hypertrophic osteopathy is a syndrome characterized by diffuse bone formation along several bones, most often those of the limbs, usually in association with a tumor located in the thoracic cavity (here, pulmonary metastases). A 6-year-old mixed-breed male Papillon dog, castrated at the age of 7 months, presented for work-up of a difficulty walking associated with constipation and urinary incontinence. Ultrasonography and radiography were consistent with a tumor of the prostate and lymph node metastases. An irregular osteoproliferation of the ventral edges of L5–L6–L7 suggested tumor invasion. Periosteal proliferative lesions of the pelvis, the femur, the humerus, the tibia and the calcaneus were consistent with hypertrophic osteopathy. Necropsy and histological examination confirmed the diagnosis of prostatic adenocarcinoma with lymph node, pulmonary, liver and bone metastases, associated with hypertrophic osteopathy. [ABSTRACT FROM AUTHOR]

Simple Summary: Oligometastatic prostate cancer has classically been defined as a small volume of prostate cancer spread as defined by imaging using CT, MRI, and bone scans. With development and integration of more sensitive functional imaging including PSMA-PET imaging more oligometastatic disease will be detected than was found with conventional imaging techniques. We are currently lacking data directing the best treatment course for these oligometastatic prostate cancer cases found on PET imaging who would have been defined as localized disease prior to PET imaging. Herein, we discuss the concept of stage migration and discuss current problems and challenges with the current definition of oligometastatic disease as imaging modalities have progressed in our field. Oligometastatic prostate cancer has traditionally been defined in the literature as a limited number of metastatic lesions (either to soft tissue or bone), typically based on findings seen on CT, MRI, and skeletal scintigraphy. Although definitions have varied among research studies, many important clinical trials have documented effective treatments and prognostication in patients with oligometastatic prostate cancer. In current clinical practice, prostate-specific membrane antigen (PSMA)-PET/CT is increasingly utilized for the initial staging of high-risk patients and, in many cases, detecting metastases that would have otherwise been undetected with conventional staging imaging. Thus, patients with presumed localized and/or oligometastatic prostate cancer undergo stage migration based on more novel molecular imaging. As a result, it is challenging to apply the data from the era before widespread PET utilization to current clinical practice and to relate current trials using PSMA-PET/CT for disease detection to older studies using conventional staging imaging alone. This manuscript aims to review the definition of oligometastatic prostate cancer, summarize important studies utilizing both PSMA-PET/CT and conventional anatomic imaging, discuss the concept of stage migration, and discuss current problems and challenges with the current definition of oligometastatic disease. [ABSTRACT FROM AUTHOR]

The incidence of secondary neoplasms of the testis has been reported at 0.02%–2.5%. The testis is a rare metastasis site for prostatic adenocarcinoma. A 62-year-old gentleman presented with neck swelling and testicular swelling. On evaluation, he was found to have metastatic carcinoma of prostate on 68-Gallium prostate-specific membrane antigen study with disseminated metastasis along with right testicular metastases. The patient underwent bilateral orchidectomy as part of the hormonal treatment, and the histopathological examination revealed the metastatic deposits on both the testis with the left testis showing only micrometastasis. Only few cases of bilateral testes metastases from the prostatic carcinoma are reported in the literature.

Objective: To investigate the incidence ERG fusion positive adenocarcinoma and its correlation with gleason grade and gleason group. Study Design: Cross-sectional study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKMCH & RC), Lahore Pakistan, from Jan 2018 to Jan 2019. Methodology: A total of 100 cases of prostatic adenocarcinoma were retrieved and ERG immunohistochemical stain was applied on all these cases. ERG expression, extent of staining, percentage of tumor cells positive for ERG, pattern of staining was recorded. We found out relationship of ERG expression and gleason grade/gleason group. Results: ERG expression was seen in 62/100 (62%) cases. Mean patient age of ERG positive prostatic adenocarcinoma patients was 69.68 years. In GG1 (14.5%) 9 cases exhibited ERG positivity. In GG2-3, 41.93% cases and in GG4-5, 43.54% cases showed ERG expression. Conclusion: To conclude, age of presentation of ERG positive adenocarcinoma was high. ERG expression was seen in 62% of our cases which was much higher than reported in other Asian countries. In our study we found a significant correlation between ERG expression and high gleason grade group.

Tissue changes and the enlargement of the prostate, whether benign or malignant, are among the most common groups of diseases that affect men and can have significant impacts on length and quality of life. The prevalence of benign prostatic hyperplasia (BPH) increases significantly with age and affects nearly all men as they grow older. Other than skin cancers, prostate cancer is the most common cancer among men in the United States. Imaging is an essential component in the diagnosis and management of these conditions. Multiple modalities are available for prostate imaging, including several novel imaging modalities that have changed the landscape of prostate imaging in recent years. This review will cover the data relating to commonly used standard-of-care prostate imaging modalities, advances in newer technologies, and newer standards that impact prostate gland imaging.

Background: B7 homolog 3 (B7‐H3) is an immunomodulatory molecule that is highly expressed in prostate cancer (PCa) and belongs to the B7 superfamily, which includes PD‐L1. Immunotherapies (antibodies, antibody‐drug conjugates, and chimeric antigen receptor T cells) targeting B7‐H3 are currently in clinical trials; therefore, elucidating the molecular and immune microenvironment correlates of B7‐H3 expression may help to guide trial design and interpretation. The authors tested the interconnected hypotheses that B7‐H3 expression is associated with genetic racial ancestry, immune cell composition, and androgen receptor signaling in PCa. Methods: An automated, clinical‐grade immunohistochemistry assay was developed by to digitally quantify B7‐H3 protein expression across 2 racially diverse cohorts of primary PCa (1 with previously reported transcriptomic data) and pretreatment and posttreatment PCa tissues from a trial of intensive neoadjuvant hormonal therapy. Results: B7‐H3 protein expression was significantly lower in self‐identified Black patients and was inversely correlated with the percentage African ancestry. This association with race was independent of the significant association of B7‐H3 protein expression with ERG/ETS and PTEN status. B7‐H3 messenger RNA expression, but not B7‐H3 protein expression, was significantly correlated with regulatory (FOXP3‐positive) T‐cell density. Finally, androgen receptor activity scores were significantly correlated with B7‐H3 messenger RNA expression, and neoadjuvant intensive hormonal therapy was associated with a significant decrease in B7‐H3 protein expression. Conclusions: The current data underscore the importance of studying racially and molecularly diverse PCa cohorts in the immunotherapy era. This study is among the first to use genetic ancestry markers to add to the emerging evidence that PCa in men of African ancestry may have a distinct biology associated with B7‐H3 expression. Lay Summary: B7‐H3 is an immunomodulatory molecule that is highly expressed in prostate cancer and is under investigation in clinical trials.The authors determined that B7‐H3 protein expression is inversely correlated with an individual's proportion of African ancestry.The results demonstrate that B7‐H3 messenger RNA expression is correlated with the density of tumor T‐regulatory cells.Finally, in the first paired analysis of B7‐H3 protein expression before and after neoadjuvant intensive hormone therapy, the authors determined that hormone therapy is associated with a decrease in B7‐H3 protein levels, suggesting that androgen signaling may positively regulate B7‐H3 expression.These results may help to guide the design of future clinical trials and to develop biomarkers of response in such trials. B7‐H3 protein expression was significantly lower in self‐identified Black patients and was inversely correlated with the percentage African ancestry. Androgen receptor activity scores were significantly correlated with B7‐H3 messenger RNA expression, and neoadjuvant intensive hormonal therapy was associated with a significant decrease in B7‐H3 protein expression, consistent with a presumed androgen receptor binding site upstream of the B7‐H3 promoter. [ABSTRACT FROM AUTHOR]

Prostatic adenocarcinoma is the second-most common cancer in men and the fifth most common cause of cancer death. Its incidence increases with age; 75% of patients are 65 years and older. The aim of the study was to assess epithelial membrane antigen (EMA) expression in prostatic adenocarcinoma as a poor prognostic marker and its correlation to some pathological parameters. The formalin-fixed, paraffin-surrounded tissue blocks were retrospectively collected from 40 men diagnosed with prostate carcinoma. All cases were collected from Al Hilla Teaching Hospital and some private labs between October 2018 -- November 2020, with ages ranging from 30--89 years. Statistical analysis was done using SPSS 22, frequency and percentage were used for categorical data, and Chi-square was used to evaluate connotation between variables. P-value ≤0.05 was significant. The blocks were sectioned for EMA immunohistochemical staining using monoclonal mouse anti-human EMA protein. EMA protein overexpression was detected in 75% (n=30/40) of prostatic adenocarcinoma cases. EMA expression showed no correlation with the patient's age (P=0.09) and a positive correlation with the cancer grade (P=0.003). In prostatic adenocarcinoma patients, EMA could be seen as a potential prognostic predictor for disease progression. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: CD10 is a zinc-dependent metalloproteinase that is associated with factors influencing the prognosis of some cancers. Prostatic adenocarcinoma is one of the most common cancers in men and Gleason grading is an important factor in its prognosis. The present study was conducted to investigate the relationship between immunohistochemical expression of CD10 and Gleason score as an indicator of prognosis in prostatic adenocarcinoma. METHODS: In this cross-sectional study, 60 paraffin blocks of prostatic adenocarcinoma samples from patients referred to Shahid Mostafa Khomeini Hospital in Tehran from 2013 to 2017 were immunohistochemically stained according to CD10 marker. Information about Gleason score was obtained by observing stained slides by hematoxylin and eosin staining method. The percentage of CD10 positive tumor cells was determined by primary and secondary Gleason score and the relationship between CD10 expression and Gleason score was evaluated. FINDINGS: The mean age of patients was 71±8.79 years. The percentage of CD10 expression varied from 5% to 62% in different samples. The mean percentages of CD10 expression in tumor cells in primary Gleason scores 2 to 5 were 10.75%, 16.16%, 35.20% and 44%, respectively and in secondary Gleason scores 2 to 5 were 10.38%, 17.08%, 38.19% and 53.5%, respectively (p

Introduction: Urine cytology is robust for the diagnosis of urothelial lesions, but data on the detection rates of prostatic adenocarcinoma in urine cytology is limited. In this study, a multicenter review was performed to define the clinical role of urine cytology in diagnosis of prostatic adenocarcinoma., Methods: Cytologic diagnoses of lower tract urine cytology specimens with histology-proven prostatic adenocarcinoma from three institutions, from a period of over two decades, were reviewed. Clinicopathological parameters-tumor grade, stage, histologic features, and preanalytical factors-prostate-specific antigen (PSA) level and lesion size, were retrieved and compared with cytologic diagnoses., Results: In total, 2115 urine cytology specimens from 1119 patients were retrieved. The atypia (or above/C3+) and suspicious (or above/C4+) rates were 19.48% and 3.36%. Bilobar and extracapsular involvement, lymphovascular invasion, Gleason score, and International Society of Urological Pathology grade were associated with a positive urine diagnosis (p < 0.05). The atypia (C3+) and suspicious (C4+) rates of urine cytology in patients with a PSA level of ≤4.0 ng/mL was paradoxically higher (p < 0.01), but PSA levels correlated positively with urine diagnosis at higher cutoffs (>10, >20, >50, >100 ng/mL). All these factors remained significant on multivariate analysis (p < 0.05), including a negative correlation with low-PSA (≤4.0 ng/mL, p = 0.001) and positive correlation with high-PSA (>20 ng/mL, p = 0.020). Lesion size and multifocality were not associated with urine cytology diagnosis (p > 0.05)., Conclusion: Urine cytology showed low sensitivity in detection of prostatic adenocarcinoma. Detection rates were largely positively correlated with PSA levels but not for lesion size nor multifocality, limiting its clinical utility., (© 2024 The Author(s). The Prostate published by Wiley Periodicals LLC.)

It is not uncommon that patients with prostate carcinoma simultaneously harbor another malignancy, but cancer-to-cancer metastasis is a rare event. We report the case of a 55-year-old man with prostatic adenocarcinoma that metastasized into a primary clear cell renal cell carcinoma, known to be the most frequent tumor-to-tumor recipient. The implications of this phenomenon with regard to diagnostic and therapeutic considerations are discussed, as well as hypotheses on pathogenetic mechanisms.

Prostate Cancer represents the second leading cause of cancer death among men in the United States, and the third leading cause of cancer death among men in Europe. We have previously shown that cells possessing Cancer Stem Cell (CSC) characteristics can be grown from human PrCa tissue harvested at the time of prostatectomy. However, the cellular origin of these CSCs was not previously known. In most cases, simple hematoxylin and eosin (H&E) stained sections are sufficient to make a definitive diagnosis of prostatic adenocarcinoma (PrCa) in needle biopsy samples. We utilized six different antibodies specific for stem cell antigens to examine paraffin sections of PrCa taken at the time of needle-biopsy diagnosis. These antisera were specific for CD44, CD133, ALDH7A1, LGR-5, Oct-4 and NANOG. We demonstrate specific staining of tumor cells with all six antisera specific for stem cell antigens. Some of these antibodies also react with cells of hyperplastic glands, but the patterns of reactivity differ from those of malignant glands. These findings demonstrate that at the time of diagnosis, PrCa consists of cells exhibiting properties of CSCs and consistent with the possibility that PrCa is a stem cell disease.

In this study, we evaluated the association of ISUP/WHO-grade groups with various pathological prognostic parameters and cancer-specific survival in patients with prostatic adenocarcinoma. We found 27 (15.7%) cases of grade group 1, 22 (12.8%) grade group 2, 30 (17.4%) grade group 3, 40 (23.3%) grade group 4 and 53 (30.8%) grade group 5 prostatic adenocarcinoma. We found that high-grade tumors (grade 3–5) had a higher frequency of perineural invasion and higher tumor volumes (>50%). Moreover, a significant association of tumor grade was noted with cancer-specific survival of patients, signifying prognostic significance of grade grouping in prostatic adenocarcinoma. [ABSTRACT FROM AUTHOR]

Background: Prostatic cancer is uncommon in dogs. Dogs with prostatic carcinoma have been reported to have a poor prognosis. Information regarding prognosis with various surgery options as well as prognosis with surgical vs. medical treatment is lacking. This retrospective study compares the outcomes of medical management to surgical treatment in dogs with prostatic adenocarcinoma and assesses the surgical outcomes of patients who underwent total prostatectomy (TP) and prostatocystectomy (TPC). The medical records of 41 dogs with prostatic adenocarcinoma, between February 2008 and June 2019, were reviewed for information on signalment, clinical signs in the initial evaluation, preoperative diagnostic imaging findings, treatment type (non-surgical or surgical), surgery type, postoperative complications, adjunctive medical therapy, and survival time. The dogs were divided into non-surgical (n = 12) or surgical (n = 29) groups. The surgical group was subdivided into the TP (n = 20) and TPC (n = 9) subgroups. Results: Age was not significantly different between the surgical (median 13.1 years [8.4–15.4] years) and the non-surgical groups (median 10.8 [7.7–15.3] years). Body weight (BW) was also not significantly different between the surgical (median 6.8 kg [2.4–34.5 kg]) and non-surgical groups (median 6.4 kg [3.7–9.12 kg]). The overall median survival time (MST) from the initial evaluation was significantly longer in the surgical than in the non-surgical group (337 vs. 90.5 days). The postoperative MST was significantly longer in the TP group than in the TPC subgroup (510 vs. 83 days). As TPC was performed in cases of tumor progression, its postoperative complications were severe, resulting in a shorter MST. Ten (50%) and 6 patients (30%) in the TP subgroup postoperatively showed mild and severe urinary incontinence, respectively, whereas all patients in TPC subgroup did show severe incontinence. Conclusion: Results of the study suggest that surgical treatment of prostatic carcinoma results in longer survival times over medical management alone. In particular, TP might be recommended for improving survival time and quality of life in canine prostatic adenocarcinoma that does not infiltrate the bladder. Early detection is key for a survival advantage with surgical treatment. [ABSTRACT FROM AUTHOR]