Flashcards in Lecture 8: Prostate Pathology Deck (50)
What is the function of the prostate gland?
It is the exocrine compound tubule-alveolar gland
Function is to secrete a slightly ALKALINE fluid (to counter acidic vagina)
Milky, or white in appearance
Usually constitutes 20-30% of semen volume along with spermatozoa and seminal vesicle fluid
Sprematozoa that is expelled in prostatic fluid have better motility, longer survival and better protection of DNA
What is the McNeal Anatomic model for prostate?
1. Glandular Compartments
2. Non-glandular compartments
What are in the GLANDULAR compartments for the Mcneal Anatomic model for the prostate?
1. Peripheral Zone (PZ)
2. Central Zone (CZ)
3. Transitional Zone (TZ)
4. Periurethral gland Region (PU)
What are in the non-glandular compartments?
1. Anterior fibromuscular stroma
2. Preprostatic Sphincter
What is the “lobe” classification of prostate used in?
Used for anatomy NOT for pathology
Anterior lobe (isthmus) = part of transitional zone
Posterior lobe = peripheral zone
Lateral lobe spans all zones
Median lobe = part of central zone
What does PUGR stand for?
Periurethral gland region
One of the 4 zones
What does PU stand for? Significance?
Used by McNeal as key anatomic landmark
What does UP stand for?
Proximal prostatic urethra
What does UD stand for?
Distal prostatic urethera
What does SV stand for?
Where do the ejaculatory ducts pass?
The central zone
What are the key characteristics of the peripheral zone?
Approximately 70% of normal gland in young men
Sub-capsular portion of the POSTERIOR aspect of the gland that surrounds the distal urethra
70-80% of prostatic cancers originate from the peripheral zone
What is the key characteristics of Central zone?
25% of normal gland
Surrounds the ejaculatory duct
Secondary involvement in prostatic cancers
What are the key characteristics of the transition zone?
5% of normal gand
Responsible for BENIGN PROSTATIC HYPERPLASIA
10-20% of prostate cancers
Surrounds proximal urethra
What are the key characteristics of the anterior fibro-muscular zone?
Devoid of glandular components
Composed only of muscle and fibrous tissue
What part of the prostate is responsible for benign prostatic hyperplasia (BPH)?
Transitional zone (TZ)
What are the two layers of cells in the prostate?
1. Basement membrane
2. Epithelial layer
What does the normal microscopic anatomy of prostate look like?
1. branching tubuloalveolar system
2. originate from urethra in curvilinear pattern
3. apical and basal layer in glands
4. FEW endocrine cells
5. glands sit in fibromuscular stroma
What types of cells in prostate?
1. secretory cells
2. Basal cells
3. Endocrine-paracrine cells
What does PSA stand for?
Prostate specific antigen
…could also be misconstrued as prostate-specific
What is the definition of BPH?
Nodular prostate enlargement due to cellular proliferation of prostatic glands and stroma associated with lower UTI symptoms
LUTS = lower urinary tract symptoms
What is the etiology of BPH?
Pathophysiology remains poorly understood
Perhaps hormonal alterations play a major role (accumulation of testosterone?)
What are risk factors of BPH?
What is the prevalence of BPH?
50% of men in 50s
80% men in their 80s
What is the most common cause of non cancerous rise in PSA?
PSA – prostate-specifc antigen
What is the significance of LUTS features?
Without lower urinary tract symptoms, glandular and stromal proliferation is NOT BPH
What is the hallmark of BPH?
Nodular prostatic enlargement
-mainly centered on proximal prostatic urethra
-involve transition zone and submucosal compartment
When do you biopsy patients who are asymptomatic??
Increased serum PSA
Abnormal digital rectal exam
Peripheral zone is enlarged (posterior)
This is prostate carcinoma
What is PCA?