A HISTOMORPHOLOGICAL STUDY OF PROSTATIC TURP SPECIMENS WITH SPECIAL REFERENCE TO PROSTATIC INTRAEPITHELIAL NEOPLASIA BY USING IMMUNOHISTOCHEMISTRY

Dr. E.Lakshmi Bai; Dr.P.Annapurna; Dr.S.Sandhya; Dr.H.Sandhya Rani

Volume : VI, Issue : X, October - 2016

A HISTOMORPHOLOGICAL STUDY OF PROSTATIC TURP SPECIMENS WITH SPECIAL REFERENCE TO PROSTATIC INTRAEPITHELIAL NEOPLASIA BY USING IMMUNOHISTOCHEMISTRY

Dr. E. Lakshmi Bai, Dr. P. Annapurna, Dr. S. Sandhya, Dr. H. Sandhya Rani

Abstract :

AIMS AND OBJECTIVES To study the histomorphological spectrum of non–neoplastic and neoplastic lesions of the Prostate in TURP specimens. To know the incidence of Prostatic Intraepithelial Neoplasia in TURP specimens. To study the association of Prostatic Intraepithelial Neoplasia in different prostatic lesions. To find out the expression of immunohistochemical markers, p63 and P504S (AMACR) in BPH, Prostatic intraepithelial neoplasia and Carcinoma cases. MATERIAL AND METHODS This is a 4 years (2 year retrospective, 2 years prospective) study which includes 130 cases, i.e., from august 2011 to july 2015 at Mahatma Gandhi Memorial Hospital, Kakatiya Medical College, Warangal. All the 130 cases were TURP specimens. RESULTS A total number of 130 cases were studied. The cases were distributed in the age group of 45–85 yrs. The maximum number of patients were in the age range of 60–69 yrs. Out of 130 cases, 104(80%) were Benign prostatic hyperplasia(BPH), 6(4.6%) were non–specific granulomatous prostatitis(NSGP), 2(4.6%) were prostatic abscess, 2(1.5%) were basal cell hyperplasia, 14(10.8%) were prostatic adenocarcinoma, and 2(1.5%) cases had both prostatic adenocarcinoma and urothelial carcinoma. Foci of Low grade prostatic intraepithelial neoplasm (LGPIN) was identified in 16(12.3%) cases. All the LGPIN foci were associated with BPH. High grade prostatic intra epithelial neoplasm (HGPIN) was identified in 18(13.8%) cases. Out of these 4(3.8%) HGPIN foci were seen in BPH and 14(87.5%) were seen associated with adenocarcinoma. 4 microscopic patterns identified in HGPIN usually with multiple patterns in each case. The percentage of tufting, flat, micropapillary and criiform patterns were 66.7%, 55.6%, 33.3% and 11.1% respectively. BPH showed 100% positivity for p63 stain and 100% negativity for P504S stain. HGPIN showed 100% positivity for p63 stain and 88.9% positivity for P504S stain. All the cases of adenocarcinoma showed negativity for p63 stain. 100% positivity was seen for P504S stain in adenocarcinoma. Both the cases of urothelial carcinoma showed positivity for p63 and P504S staining. CONCLUSION BPH is the most common lesion of the prostate in the elderly. Conventional adenocarcinoma is the commonest type of prostatic carcinoma. HGPIN has a high degree of association with prostatic carcinoma. Basal cell marker p63 is really helpful in differentiating benign and HGPIN glands from malignant glands. P504S is of great value in differentiating HGPIN and malignant glands from benign glands.