productivity

1. Prostate

2. Retroperitoneal organ
Encircling the neck of the bladder
~ 20 gms

3. Anatomical zones
Central
Peripheral
Transitional
Ant. Fibromuscular stroma

4. Histology
Glandular organ
Lined by 2 cell layers
• Basal layer – low cuboidal epithelim
• Columnar secretory cells

5. Prostate pathologies
Inflammations
Benign nodular enlargement
Tumors

6. Inflammations
Acute / Chronic Prostatitis
E. coli

7. Benign enlargement
Benign prostatic hyperplasia (BPH)
Age > 50 years
Hyperplasia of stromal and epithelial cells
Formation of large nodules in the prostate in
the periurethral region. (Transitional zone)

8. Nodules – Compress the urethra

9. Histological changes seen in 70% men
Above the age of 60 yrs..
But only 50% have clinicaly detected
enlargemnt
50% have symptoms

10. What is the cause?
‘Dihydrotestosterone’

11. Morphology
60 – 100 gms
Location – inner areas of the gland
Arise in the Transitional zone
M/E – Glandular proliferation
Stromal proliferation

12. Symptoms
Compression – Difficulty in urination
Retension of the urine in the bladder
Distension & hypertrophy of the bladder
Urine infections, Renal infection..
Difficulty in starting the urination, dysuria,
Acute urinary retention

13. Nodular hyperplasia –
Not a premalignant condition

14. Tumors
Adenocarcinoma

15. Most common cancer in the men
Racial differences

16. Etiology
Advancing age
Diet - ?
Fats
Prevent the cancer – Lycopenes
Vit A, E, Selenium

17. Etiology
Increased sensitivity to androgens

18. Morphology
70% cases – Peripheral zone
Posterior in location
(rectal examination)
Firm

19. Direct local invasion
Blood route – Bones
Osteoblastic
Lumbar spine
Femur
Pelvis
Ribs

20. M/E
Adenocarcinoma
Glandular pattern
Single layer of cuboidal epithelium
Crowded glands , Folded, branching
Perineural invasion

21. PIN

22. Grading & Staging
Gleason system
5 Grades
Glandular pattern and differentiation
On Low power

23. Grading – Best marker for prognosis

24. Staging – TNM system
Nodes ? Metastasis?
T1 –
T2 –
T3 – Extra prostatic spread
T4 – Node involved, Direct spread outside

25. PSA
Prostate specific antigen
4ng/ml