Pathological aspects of prostate cancer aggressive behavior. Personal experience in differentiating data.
PSA screening is a tremendous burden for the pathologist, who has to see so many biopsies, but it is not only an intellectual burden to make a right diagnosis, it is also a real logistic burden. The TNM stage of the cancer detected has also changed. It's become more and more organ-confined cancer. Small volume of cancer in the biopsy is frequently consistent with an organ-confined cancer, but not necessarily with a small cancer. Another problem is the nonsense of the TNM (2002) staging of prostate cancer. You can have a voluminous cancer in one lobe with a bad prognosis which is classified as pT2b. Two or more small cancer foci in both lobes with a small tumor volume and good prognosis correspond to pT2c. Such a staging does not make any sense, and should be changed in the future. One of the most frequent (up to 90%) lesions encountered in prostate biopsies are the atrophic areas. Inexperienced pathologists can easily mistake this lesion for cancer. These nuclei are really ugly looking, and if you use proliferation markers, they proliferate like cancer, or even more. The chromosomal marker most frequently associated with prostate cancer genesis and progression is the long arm of 8q24.
Mikuz
Gregor
G
Institute of Pathology-Medical University, Innsbruck, Austria. Gregor.Micuz@uibk.ac.at
D001706:Biopsy; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology*