Histopathological Overview of Common Prostatic Lesions

Abstract

Objective: To determine the frequency of different prostate lesions in our population regarding age and to grade carcinoma prostate according to the Modified Gleason Grading System.
Material and Methods: A 3-year retrospective study of prostate biopsies received at the Pathology Department, Central Park Teaching Hospital /Central Park Medical College, Lahore from 1st January 2021 to 31st December 2023. Previous records were reviewed regarding age, type of surgical specimens, diagnosis and Gleason grading in prostate cancer cases. Statistical analysis using SPSS version 21 was utilized for calculations.
Results: Out of 260 prostate biopsies, 251(96.53%) specimens were transurethral resection of prostate (TURP), 6(2.30%) cases were core needle biopsies (CNB) and 3 (1.15%) cases were radical prostatectomy (RP) specimens. Benign cases constituted of 230 (88.46%) cases which included 200 (86.95%) cases of benign prostate hyperplasia (BPH) and 30 (13.04%) cases of BPH with associated prostatitis. Malignancy was reported in 30 (11.03%) cases. Patient's age ranged between 40-95 years with cases in the age group of 61-70 years constituting of 100 (38.46%) cases. These included 89 (38.69%) cases of BPH and 11 (36.60%) malignant cases. Maximum number of malignant cases were seen in age >70 years constituting of 13(43.33%) cases. Ten (33.33%) cases of carcinoma prostate had Gleason grade 5 and 8 (26.66%) cases had Gleason grade 4. Perineural invasion was noted in 24 (80%) cases.
Conclusion: All prostatic lesions predominate in the older age group. Benign lesions outnumber malignant
lesions by a ratio of almost 8:1 with the commonest biopsy being TURP. Majority of prostate cancers had high
Gleason grade groups of 4 & 5.
Keywords: Benign prostatic hyperplasia, prostatitis, carcinoma prostate, Gleason grading system.