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THE PROSTATE NORMAL PROSTATE • FIBROMUSCU – LAR stroma • Glands with EPITHELIUM and BASAL CELLS prostate • INFLAMMATION • HYPERPLASIA • NEOPLASIA INFLAMMATION • BACTERIAL, including TUBERCULOSIS • • • • IDIOPHATIC GRANULOMATOUS: The prostate becomes hard and irregular Elevated PSA Can be mistaken for cancer on palpation Nodular / Adenofibromyomatous HYPERPLASIA PROSTATE CANCER • • • • • Almost always ADENOCARCINOMA 75 % of patients are > 75 years old Occurs in the peripheral zone Multifocal Scandinavia and the USA have the highest frequency; more common in blacks How it is detected: • An elevated PSA is found at urological examination ; • Normal level: 4ng / ml • Incidentially in TUR P material when hyperplasia is symptomatic and diagnosed: • Core biopsies (6 – 12 from the periphery of the prostate) • Fine needle aspiration is nowadays done only to document an already known tumour Prostatic Intraepithelial Neoplasia • PIN <> GLEASON GRADING Gleason grade 2 GLEASON GRADE 3 GLEASON GRADE 3 Basal cells GLEASON GRADE 3 Gleason grade 4 Gleson grade 5 Gleason grade 5 Perineural tumour growth
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