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Indian Journal of Pathology: Research and Practice

Volume  8, Issue 5, September - October 2019, Pages 661-665
 

Original Article

Histomorphological Study of Premalignant Lesions of Prostate in TURP Samples

Swati Sahay1, Aditya Vikram Singh2, Sateesh Jighjini3

1,2Post graduate student 3Professor, Dept. of Pathology, S Nijalingappa Medical College, HSK (Hanagal Shree Kumareshwar) Hospital and Research Centre, Bagalkot, Karnataka

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.8519.22

Abstract

Carcinoma prostate falls next to carcinoma lung in incidence and mortality rate. With increasing age of men incidence of prostatic carcinoma is seen to be increasing. In recent years significant achievement is made in early diagnosis and the detection of carcinoma prostate. Technologies such as immunohistochemistry, flow cytometry, fluorescent in situ hybridization (FISH) have helped in the study of premalignant and malignant lesions of prostate. Concept of Intra epithelial development of carcinoma progressing to invasive is a well-recognised phenomenon with cervical cancer, oral cancer and so also the carcinoma Prostate. Orteil in 1926 gave the first description of premalignant changes in the prostate. The premalignant lesions of prostate include prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH) and recently, the new lesion added to the list of premalignant lesion is proliferative inflammatory atrophy (PIA). Screening for prostate cancer is controversial. Although the past several decades have seen declines in overall prostate cancer mortality, some evidence exists that this is a function of improved survival for men with advanced prostate cancer rather than men with early-stage disease who presumably would benefit from screening. It is recommended by-American Urological Association that in general, men 50 years and older with a reasonable certainty of a 10-year life expectancy should be screened annually or biennially. Patients with an elevated risk of disease (e.g., African Americans and those with a family history) should be screened beginning at an earlier age (45 years). In this part of our country the socio-economic conditions and the facilities pose limitations for people screening to be undertaken. In clinical practice, AAH, HGPIN and PIA remains undetected as most of these lesions does not reveal any abnormality on clinical (digital rectal examination), biochemical (PSA level analysis and radiological (trans rectal ultrasound) evaluation. Hence, histopathology remains the gold standard for diagnosis of these putative precursor lesions of prostatic carcinoma. Identification of these lesions of prostate will help in early detection of carcinoma and guide the urologist for appropriate management of the patient.

Keywords: BPH; PIN; CARCINOMA; P63; AMACR.


Corresponding Author : Aditya Vikram Singh