[1012] Incidental Secondary Pathological Findings in Prostate Needle Biopsies and Radical Prostatectomy Specimens

Frances L Rosario-Quinones, Pamela D Unger, Guang-Qian Xiao. Mount Sinai Medical Center, New York, NY

Background: Prostate needle biopsies and radical prostatectomies have become increasingly common specimens examined by pathologists. Existing literature has mainly focused on the main three pathologic processes that commonly affect the prostate gland; benign prostatic hyperplasia, inflammation, and carcinoma. No existing literature has systemically looked into additional pathologic processes in the prostate gland. We present a series of secondary pathologies identified in prostate biopsies and radical prostatectomies over the course of six years.
Design: We retrospectively and prospectively reviewed all the prostate biopsies and radical prostatectomies collected at our institution between 2006-2012. A total of 8350 cases were reviewed, 135 of these were radical cystoprostatectomies for bladder cancer, with or without concurrent prostate cancer. Pelvic lymph node dissections pertaining to radical prostatectomies were also included in the study.
Results: Secondary pathological findings were identified in 135 of the reviewed cases. (Table 1)

Table 1. Incidental Secondary Pathologies Found in Prostate Specimens
FindingProstate BiopsiesRadical Prostatectomies
  ProstatePelvic Lymph Nodes
Granulomas11*9*12**
Seminal Vesicle Amyloid836 
Lymphoma2† 4††
Malakoplakia21 
Periprostatic Atherosclerosis‡   
Mild 27 
Moderate 17 
Severe 6 
*Bacillus Calmette-Guerin (BCG) related. **3 cases were related to femoral prostheses, 9 cases had no known cause. † 1 small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL), 1 diffuse large B-cell lymphoma. †† All 4 cases were SLL/CLL. ‡ 50 consecutive cases were reviewed


Conclusions: Our studies revealed periprostatic atherosclerosis as the most common incidental secondary pathology found in prostate specimens, reflective of the elderly population in this study. Seminal vesicle amyloidosis was the second most common finding. This is a localized form of amyloid disease and is usually asymptomatic. Granulomas were the third most common finding, seen in prostate biopsies, radical prostatectomies, and pelvic lymph nodes. The majority of these were attributable to BCG treatment for bladder carcinoma. Lymphomas involving the prostate and pelvic lymph nodes are rare, but could be the first indication of disease recurrence. Malakoplakia of the prostate gland is extremely rare, but one needs to recognize this lesion to avoid the pitfall of over diagnosing a carcinoma. In summary, although rare and mostly inconsequential, secondary pathologies found in prostate specimens may be of clinical importance and could prove useful in assisting medical treatment.
Category: Genitourinary (including renal tumors)

Wednesday, March 6, 2013 1:00 PM

Poster Session VI # 154, Wednesday Afternoon

 

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