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Prostatic 'capsule'--a comparative study of histological and ultrasonic appearances
M P Young1, D R Jones, G J Griffiths
1Department of Histopathology, University College, London Medical School, UK.
European Urology
|January 1, 1993
Summary
Transrectal ultrasound (TRUS) may underestimate prostate cancer extent. The study found the ultrasound
Area of Science:
- Urology
- Pathology
- Medical Imaging
Background:
- The prostate gland capsule is a critical landmark for staging prostate cancer.
- Transrectal ultrasound (TRUS) is commonly used for visualizing prostate anatomy and guiding biopsies.
- Accurate assessment of tumor extent is crucial for effective treatment planning.
Purpose of the Study:
- To compare the histological and transrectal ultrasound (TRUS) appearances of the prostate gland periphery.
- To evaluate the reliability of the 'ultrasonic capsule' as a landmark for prostate cancer staging.
- To propose alternative terminology for describing tumor extent.
Main Methods:
- Autopsy specimens of 30 benign and 27 malignant prostates were analyzed.
- Histological examination of the prostate capsule was performed.
- Corresponding sites were evaluated using transrectal ultrasound (TRUS).
Main Results:
- In benign prostates, the histological capsule was often absent, correlating poorly with a well-defined TRUS 'capsule'.
- In malignant prostates, no correlation was found between unconfined cancers and ultrasound capsule appearance.
- This disparity suggests TRUS may underestimate tumor extent.
Conclusions:
- The term 'ultrasonic capsule' is an unreliable landmark for prostate cancer staging.
- A revised terminology describing tumors as intra- or extra-prostatic, or confined/unconfined, is recommended.
- TRUS findings may lead to underestimation of prostate cancer spread.