Histopathology of prostate cancer

Prostate cancer is a malignant tumor arising from the prostate alveolar or ductal epithelium, mainly adenocarcinoma, accounting for about 97%; squamous cell carcinoma, transitional cell carcinoma, carcinoid, undifferentiated carcinoma, etc., only account for 3%.

Prostate cancer can be divided into the following four categories based on clinical and pathological characteristics:

1. Clinical cancer

Clinical cancer has local symptoms, obvious invasion and late metastasis. It usually originates from the peripheral zone of the prostate and may not invade the peripheral zone of the urethra for a long time. Its morphology is often well-differentiated adenocarcinoma when observed under a microscope.

2. Hidden cancer

The primary focus of occult cancer is small and lacks local symptoms, making it difficult to be discovered. However, it often metastasizes widely. Metastatic cancer is first discovered clinically, and after a comprehensive examination, prostate cancer is found to be the primary focus. The prostate of patients with occult cancer may be slightly enlarged without serious structural damage. Microscopic observation shows that it is poorly differentiated adenocarcinoma or simple carcinoma.

3. Occasional cancer

Incidental cancer is diagnosed as a non-malignant disease, and postoperative pathological examination unexpectedly finds prostate cancer. Incidental cancer of prostate hyperplasia has the following pathological characteristics: ① Incidental cancer is accompanied by prostate hyperplasia ② Incidental cancer and prostate hyperplasia nodules are long-term confined to the central area; ② Often multiple lesions, and very similar to adenomatous nodules of prostate hyperplasia; ④ Mainly expand to the various bands around the urethra, not to the peripheral band; ⑤ Histological examination is very similar to typical prostate glandular hyperplasia or atypical hyperplasia, and sometimes it is difficult to distinguish histologically. Most incidental cancers are well-differentiated cancers with a good prognosis.

4. Latent cancer

Latent cancer is characterized by being small, asymptomatic, and non-metastatic. It is often found during autopsy and is usually well-differentiated adenocarcinoma with invasion of the stroma under microscopic observation.