Original and infiltrating patterns of prostatic carcinoma

Area of Science:

• Uropathology
• Oncology
• Histopathology

Background:

• Prostatic carcinoma exhibits diverse histological patterns.
• Understanding these patterns is crucial for diagnosis and prognosis.
• Cancer volume influences histological characteristics.

Purpose of the Study:

• To investigate the relationship between total cancer volume and histological features of prostatic adenocarcinoma.
• To elucidate the original and infiltrating patterns of prostate cancer.
• To analyze changes in Gleason grading patterns with increasing tumor size.

Main Methods:

• Histopathological review of 196 radical prostatectomy specimens.
• Classification of tumors into three volume groups: <0.5 cm(3), 0.5–1 cm(3), and ≥1 cm(3).
• Analysis based on the 2005 International Society of Urological Pathology (ISUP) Gleason Grading system.

Main Results:

• In smaller tumors (<0.5 cm(3)), Gleason primary patterns 3 (64.4%) and 4 (26.7%) were prevalent.
• Gleason secondary patterns 3 (53.3%) and 4 (42.2%) were also observed.
• Increased cancer volume correlated significantly with a higher percentage of cribriform patterns (Gleason pattern 3) (p<0.01).
• Prostatic carcinoma demonstrated early infiltration of surrounding stroma, ducts, and acini.

Conclusions:

• Prostate cancer's original pattern consists of small acini (Gleason patterns 3 and 4) without cribriform formation.
• Tumor infiltration begins early, affecting adjacent structures and contributing to volume increase.
• Histological characteristics, particularly cribriform patterns, evolve with increasing cancer volume.