Rajal B. Shah, M.D., University of Michigan, Ann Arbor, MI, Ming Zhou, M.D., Ph.D, Cleveland Clinic Foundation, Cleveland, OH
In the PSA screening era, the number of patients undergoing prostate biopsies has increased dramatically. There is also a trend to perform extended biopsy sampling, or “saturation biopsy” to improve cancer detection in the contemporary practice. This has lead to detection of much smaller lesions that pose a significant challenge to surgical pathologists who are “in the hot seat” to provide accurate diagnosis and prognostic information in small needle threads.
The objective of this short course is to cover all the practical issues related to the interpretation of prostate needle biopsies in day-to-day practice. Specifically, this course will discuss: 1) Contemporary needle biopsy indication, strategy and significance; 2) Diagnosis of limited cancer in needle biopsy; 3) Issues related to “atypical”, or ASAP diagnosis; 4) Benign mimickers of prostate cancer; 5) Prostate cancers that mimic benign lesions; 6) HGPIN and its significance, particularly in the contemporary practice; 7) Contemporary approach to Gleason grading in needle biopsies, and other relevant histological prognostic information; 8) Immunohistochemical and other emerging diagnostic markers; 9) Reporting of prostate needle biopsy; and 10) Biopsy processing considerations.
Case based approach will be used in this course. Numerous cases will be discussed to illustrate the prototype microscopic findings as well as the wide morphological spectrum for the prostate lesions. All participants will receive a CD with multiple representative images used in the course together with a syllabus.
After completion of this course, participants should be able to diagnose limited prostate cancer, differentiate it from numerous benign mimickers, apply prudently the diagnostic immunohistochemical markers, and be familiar with contemporary issues related to biopsy sampling. Gleason grading and other prognostic information necessary to provide in the report.