[Histologic-ultrasonographic correlation of gland asymmetry and "pseudoruptures" of the prostatic capsule]

An histo-ultrasound correlation was carried out between the information obtained with pre-operative transrectal ultrasound and that obtained with the histopathological study of 29 prostate specimens from patients with mean age 63 years (range, 52 to 71 years), who underwent radical cystoprostatectomy for infiltrant neoplasia of the bladder (22/29) and radical prostatectomy for prostate cancer (7/29). The (extrinsic and intrinsic) ultrasound parameters were analyzed focusing in the study of the prostatic capsule or "pseudocapsule". With this comparative, echographic and histological study the concept of capsular "pseudorupture" that results from the presence of (arterial and/or venous) vessels, nerves and fibromuscular folds at the periprostatic fat tissue is introduced. The interruption of the capsular echogram was seen as an indication of tumoral involvement of the capsule, and extracapsular spread. Our results allow us to suggest that this assertion should be reconsidered since these capsular "interruptions", "irregularities" or "pseudoruptures" are present in the normal prostate. Similarly, glandular asymmetry in relation with an heterogenous growth in one lobe in defined to differentiate it from that seen in neoplastic processes.