Clinicopathological study of prostatic biopsies

Prostatism is a common malady in the geriatric age group. Benign prostatic hyperplasia and Carcinoma of the prostate are increasingly frequent with advancing age. The aim of the present study is to study the spectrum of prostatic lesions among the biopsies received in a rural hospital.

One hundred and six cases of prostatic biopsies received in the Department of Pathology, Rajah Muthiah Medical College and Hospital - Annamalai University were included in the present study. There were 44 needle biopsies and 62 TURP specimens. All the specimens were fixed in 10% neutral buffered formalin and 5μ sections were stained with Hematoxylin and Eosin stain (H & E stain). Relevant clinical data including age, the presenting complaints and S.PSA values in suspected cases of carcinoma prostate were recorded.

Among the 106 biopsies received, 79 (74.52%) cases were of Benign prostatic hyperplasia, two cases (1.89%) were Prostatic intraepithelial neoplasia and 25 cases (23.58%) were Carcinoma of Prostate. Prostatitis was the most common associated lesion in cases of benign prostatic hyperplasia presenting in 25.31% patients. Among the Carcinoma patients, 20 cases (80%) were of Adenocarcinoma of prostate and 5 cases (20%) were Small cell carcinoma of prostate. Both Benign prostatic hyperplasia and Carcinoma prostate were common in the seventh decade. Most common clinical presentation was difficulty in micturition. Most common histological type of Carcinoma prostate was Adenocarcinoma. Serum PSA estimation was done in 49 cases of prostate biopsies. Elevations of serum PSA levels were noted in both BPH and Carcinoma prostate patients.Eight cases of BPH, had serum PSA values in the range of 0-4ng/ml. Six cases of Carcinoma prostate ,had serum PSA values in the range of >80 ng/ml.

Benign prostatic hyperplasia is the most commonly encountered prostatic lesion. Although, investigations like transrectal ultrasonogram and serum PSA estimation aids in diagnosis, a definitive diagnosis of benign and malignant lesions of prostate can be made by histopathological study of prostatic biopsies.