2016 Annual Meeting

SC10-Diagnostic Challenges in Prostate Pathology

Room CC 611-612, March 17 2016, 8:00am to 11:30am


SC10-Diagnostic Challenges in Prostate Pathology

Session Credits: 3 CME and 3 SAMs

Faculty: Adeboye Osunkoya, MD, Emory University, Atlanta, GA and Cristina Magi-Galluzzi, MD, PhD, Cleveland Clinic, Cleveland, OH

Specimens obtained from prostate needle core biopsies, transurethral resection of prostate and radical prostatectomies are very common, and are frequently handled in both academic institutions and private practices by general surgical pathologists and/or urologic pathologists. These specimens still continue to pose diagnostic challenges in day to day practice. Benign tumor-like lesions of the prostate are often over diagnosed as prostate cancer or atypical small acinar proliferation. Secondary tumors involving the prostate are frequently misdiagnosed as prostate cancer. Histological variants of prostate cancer with important clinical significance are under-recognized. Extraprostatic extension on prostate needle core biopsy is frequently missed. Diagnosis of minimal adenocarcinoma in prostate needle biopsy is often challenging and relies on appropriate interpretation of immunohistochemical stains. Importance changes in Gleason grading/scoring system recently introduced may be underappreciated. Recognition of changes occurring in prostate tissue as a result of treatment effect are critical, but may be missed. This course will be presented by two experienced Urologic pathologists (with over 200 publications combined) who will deliver approximately 3 hours of lectures including time for questions. A case-based format will be used for this course. Ten cases that illustrate recurrent diagnostic problems and challenges in prostate pathology have been selected, and these cases will be used as springboards to discuss diagnostic approaches and differential diagnoses/pitfalls. The target audience includes general surgical pathologists, urologic pathologists, pathology residents and fellows. Still images along with brief clinical histories will be posted on the USCAP website for review by course registrants prior to the meeting. A comprehensive syllabus (with 40 pages of text and a list of references) reviewing diagnostic features and differential diagnoses/pitfalls will be made available online prior to the course. After the meeting, all course registrants will also have access to the PowerPoint slides presented at the course on the USCAP website.

Upon completion of this educational activity, participants should be able to:

  1. Recognize the most common benign mimickers of prostate cancer and be aware of potential diagnostic pitfalls
  2. Identify secondary tumors involving the prostate and distinguish them from prostate cancer
  3. Recognize some variants of prostate cancer and how to distinguish them from secondary tumors
  4. Confidently identify extraprostatic extension on needle core biopsy and be aware of potential diagnostic pitfalls
  5. Recognize atypical glands suspicious for but not diagnostic of cancer and minimal adenocarcinoma
  6. Understand the utility and pitfalls of immunohistochemical stains in prostate pathology
  7. Know the importance of recent changes in Gleason grading
  8. Recognize changes occurring in prostate tissue as a result of treatment effect.


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