good morning, have a nice time. what’s new about lesions of prostatic gland? by taghreed abd...
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![Page 1: Good morning, have a nice time. What’s new about lesions of prostatic gland? By Taghreed Abd El_Sameea Ass. Prof. of pathology Faculty of Medicine Benha](https://reader035.vdocuments.mx/reader035/viewer/2022081603/5697bfc11a28abf838ca468a/html5/thumbnails/1.jpg)
Good morning, have a nice time
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What’s new about lesions of prostatic gland?
By Taghreed Abd El_Sameea
Ass. Prof. of pathologyFaculty of Medicine
Benha University
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Relation to adjacent organsurinary bladder, prostate and different duct sagittal section
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Prostatic carcinoma
• Causes:• Genetic:
- Dietary: Trans fats
- Medication exposure: conversion of testosterone to dihydrotestosterone
- Viral elements: HPV
- -precancerous lesions( LGPIN, HGPIN and ASAP)
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Precancerous lesions in the prostate
• carcinoma in situ or prostatic intraepithelial neoplasia (PIN) that includes LGPIN, HGPIN and ASAP
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LGPIN, note the irregular spacing of the lining epithelium with nuclear hyperchromasia and more frequent
inconspicuous nucleoli
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Tufting, papillary formations and signet ring patterns (intraluminal signet ring neoplastic cells) confined to a pre-
existing gland, as demonstratedby positive basal cell staining in HGPIN
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HGPIN/ micropapillary and cribriform patterns, note more benign appearing cytology towards center of gland .
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HGPIN, papillary pattern and mucinous type with flat pattern of growth, note filling the gland by blue mucin
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Diagnosis of PIN
• 1- Needle biopsy
• 2- TURP
• 3- TRUS
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Gross pattern of normal prostate versus prostatic carcinoma
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Ductal adenocarcinoma of the prostate. Papillary type of growth, Cribriform pattern.
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invasive prostatic adenocarcinoma. • The neoplastic cells are arranged in glands around central lumens.
• Delicate fibrovascular stroma separates the malignant glands. • The neoplastic cells have prominent nucleoli and little cytoplasm.
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Early diagnosis of prostatic carcinoma
• Engrailed-2 (EN2) in the urine is highly senstive
• Digital rectal examination
• Ultrasound (US) and Magnetic Resonance Imaging (MRI)
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Role of tumor markers in diagnosis and follow up in patients with prostatic carcinoma
• PSA and PAP
• BCL-2
• Ki-67 ERK5
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Prevention of prostatic caner
• Medications• Two medications which block the conversion of
testosterone to dihydrotestosterone, finasteride and dutasteride,.
• Vaccine, under trial
• Ejaculation frequency may decrease a man's risk of prostate cancer. Diet: fish , Omega-3 fatty acids • Trans fats may be associated with an increased risk
of cancer
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recommendations
• Starting at age 50 years, (45 years if your brother or father suffered from prostatic lesion before age 65)
• Engrailed-2 (EN2) in the urine
• Digital rectal examination may allow a doctor to detect perepheral zone prostate abnormalities.
• Biopsy.
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Thanks to all, good bye