Prostate&Seminal vesicle

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Figure 26.1 Normal central zone glands with typical "Roman bridge" formations and intraluminal papillary infolding

Figure 26.2 Eosinophilic Paneth-like neuroendocrine granules in benign prostatic glands

 Figure 26.3 Gross appearance of nodular hyperplasia in material obtained from suprapubic prostatectomy. Note the multinodular appearance and the admixture of solid and microcystic areas

Figure 26.4 Stromal Nodule in Benign Prostatic Hyperplasia. The characteristic prominent blood vessels may be seen even at low power

 Figure 26.5 Nodular hyperplasia of prostate on TUR with detached well-circumscribed nodules of glands. TUR, Transurethral resection

Figure 25.6 Gross Appearance of Infarct of Prostate. The lesion has a bright red color and bulges on the cut surface. Nodular hyperplasia is also present

Figure 26.7 Prominent squamous metaplastic changes at the edge of a prostatic infarct. These are sometimes overdiagnosed as carcinoma

Figure 26.8 Nonspecific Granulomatous Prostatitis. The inflammatory infiltrate, which contains scattered multinucleated cells, is characteristically centered on a prostatic acinus

Figure 26.9 Benign Seminal Vesicle Epithelium Present in a Prostatic Needle Biopsy. The marked nuclear pleomorphism, which is characteristic, may prompt an overdiagnosis of carcinoma. Note the abundant intra- cytoplasmic pigment

 Figure 26.10 Mesonephric remnants within periprostatic stroma. (Courtesy of Dr. Samson Fine, Memorial Sloan Kettering Cancer Center, New York, NY.)

Figure 26.11 Postatrophic hyperplasia of the prostate retains its lobular architecture

 Figure 26.12 Partial atrophy, the most common mimic of prostatic carcinoma in routine practice, may be pseudoinfiltrative; however, the angulated/tapered shape of the glands and the loss of luminal cytoplasm are characteristic

Figure 26.13 Basal cell hyperplasia often grows as solid nests or cir- cumferential nodules of dark cells around residual prostatic secretory cells

 Figure 26.14 Clear cell hyperplasia of prostatic transition zone with a focally cribriform pattern of growth

Figure 26.15 Sclerosing Adenosis of Prostate. The features are similar to those of its better-known mammary counterpart

Figure 26.16 Adenosis of the prostate is characterized by crowded benign glands mimicking a well-differentiated adenocarcinoma

 Figure 26.17 A, Radiation changes in prostate: the acini show marked nuclear pleomorphism. On low power, the lobular architecture was retained. B, Immunostain for GATA3 shows nuclear reactivity in the atypical cells, which may cause confusion with urothelial carcinoma

Figure 26.18 Gross Appearance of Prostatic Adenocarcinoma. The tumor appears as an irregularly shaped, yellow mass with punctate foci of necrosis in a gland that is also involved by nodular hyperplasia

Figure 26.19 Whole mount of radical prostatectomy specimen showing involvement by an extremely small prostatic carcinoma located at the periphery of the organ and accompanied by perineurial invasion, the latter better seen in the inset

 Figure 26.20 Microscopic Appearance of Prostatic Carcinoma. Well-differentiated Gleason score 3+3 = 6 adenocarcinoma composed of medium-sized glands. Note the irregular shape of the glands and presence of intraluminal basophilic secretion. The contrast with the non-neoplastic glands present in the field is obvious

Figure 26.21 Gleason score 3+3 = 6 prostatic adenocarcinoma composed of small crowded glands

 Figure 26.22 Poorly differentiated Gleason score 5 + 5 = 10 prostatic adenocarcinoma growing in a diffuse fashion. The appearance is remi- niscent of that of invasive lobular carcinoma of breast

Figure 26.23 Prostatic adenocarcinoma with cribriform histology

Figure 26.24 Prostatic adenocarcinoma with glomerulations is regarded as Gleason pattern 4

Figure 26.25 Prostatic adenocarcinoma with mucinous fibroplasia/ collagenous micronodules

Figure 26.26 Well-differentiated prostatic adenocarcinoma showing intraluminal crystalloids

Figure 26.27 Prostatic adenocarcinoma with foamy gland features. The nuclei are often small and condensed in this specific variant

Figure 26.28 Prostatic adenocarcinoma with atrophic features. Despite the lack of cytoplasm, the glands were infiltrative and the nuclei maintained cytologic features of carcinoma

Figure 26.29 Prostatic adenocarcinoma with PIN-like features

Figure 26.30 A, H&E section of an aberrant p63 expressing carcinoma showing somewhat atrophic features with paired p63 immunostaining (B). Importantly, the nuclear staining is in a secretory cell pattern, not a basal cell pattern

Figure 26.31 Whole Mount of Ductal Adenocarcinoma. The tumor is centrally located and has a distinctly papillary configuration

Figure 26.32 Ductal adenocarcinoma of prostate with papillary features

Figure 26.33 Ductal adenocarcinoma of the prostatic urethra mimicking a benign polyp or a papillary urothelial neoplasm

 Figure 26.34 Immunohistochemical multiplex stain with HMWCK, p63, and P504S. The carcinoma cells show strong circumferential luminal staining for P504S with an absence of basal cells

Figure 26.35 Small cell carcinoma of the prostate, morphologically identical to its lung counterpart

Figure 26.36 Mucinous Adenocarcinoma of Prostate. Most of the mucin is located extracellularly

 Figure 26.37 Adenosquamous carcinoma of the prostate gland, occurring after radiation therapy

Figure 26.38 So-called adenoid basal cell tumor of prostate. The central tumor nest shows an appearance reminiscent of that seen in adenoid cystic carcinoma of salivary glands

Figure 26.39 Sarcomatoid carcinoma of the prostate gland

Figure 26.40 Pleomorphic giant cell carcinoma of the prostate gland

Figure 26.41 High-grade prostatic intraepithelial neoplasia

 Figure 26.42 A, Intraductal carcinoma is characterized by a dense population of malignant cells filling the lumen. B, By definition, there is an intact basal cell layer (high molecular weight keratin, p63, and racemase stain)

 Figure 26.43 Extraprostatic extension as evidenced by prostatic adeno- carcinoma extending into adipose tissue

Figure 26.44 Prostatic adenocarcinoma, Gleason score 3 + 3 = 6/10 (Grade Group 1) characterized by distinct well-formed glands

Figure 26.45 Prostatic adenocarcinoma, Gleason 3 + 4 = 7/10 (Grade Group 2). Pattern 4 is composed of "poorly formed glands."

Figure 26.46 Gleason pattern 4 carcinoma characterized by cribriform glands

Figure 26.47 Gleason pattern 5 characterized by solid sheet-like growth

Figure 26.48 A, Outer aspect and B, cut surface of embryonal rhab- domyosarcoma of prostate in a child

 Figure 26.49 Prostatic stromal neoplasm of uncertain malignant potential with bland cytology

Figure 26.50 Prostatic stromal sarcoma with phyllodes-like pattern (A) showing marked cytologic atypia (B)

Figure 26.51 Angiosarcoma with epithelioid features involving the prostate. Note the cytoplasmic vacuolization. The diagnosis was confirmed immunohistochemically

 Figure 26.52 Mixed epithelial-stromal tumor of seminal vesicle

Figure 26.53 Normal benign Cowper's gland on needle core biopsy has features similar to minor salivary gland tissue