Histopathological Study of Prostatic Biopsies in Men with Prostatism

Abstract

Background: Prostatism is an ailment of the geriatric age group leads to a colossal morbidity worldwide. Benign prostatic hyperplasia followed by prostatic adenocarcinoma account for most of the cases of prostatic disease. The concept of geriatrics has not been well-established in India. With increase in life expectancy, better education and increased public awareness the specific diagnosis offered to men with prostatism would increase. Objectives: The present study was done to determine the spectrum of pathological lesions in transurethral resection prostate (TURP) and needle biopsies from men with prostatism and to analyze the clinical and microscopic anatomy of the lesions encountered. Materials and Methods: 2 years prospective study from September 2012 to August 2014 in the Department of Pathology, MVJMC and RH, rural Bengaluru on 62 cases of prostate biopsies in men with prostatism. The clinical and laboratory data of each patient were noted from the case records. The clinical and histomorphology findings of the pathological lesions encountered were analyzed. Results: A total of 62 prostate biopsies were studied over a 2-year period which included TURP (88.70%) and needle biopsy specimens (11.30%). The most common pathology encountered was benign lesions constituting 80.6% (50 cases). Premalignant and malignant lesions constituted 19.4% (12 cases). Both benign and malignant lesions were common in the age group of 51-80 years and had presented clinically with frequency, hesitancy, and dysuria. Gleason's score of 7 was the most common, seen in 36.3% of cases. Gleason score of 8 and 9 was seen in 27.2% cases each. One case of adenocarcinoma showed neuroendocrine differentiation. Conclusion: More studies are needed in future to identify environmental and psychosocial factors contributing prostate disease. All prostate carcinomas encountered were of high-grade. Hence, screening of the rural population would have a definitely have a positive impact on the patient outcome.