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Treated Prostate Carcinoma

Image A

Image B

Radiation therapy

  • Changes in tumor cells are variable, but in general, the tumor starts looking worse - the Gleason's score appears to go up although the prognosis doesn't change (which is why you cannot render a Gleason's grade on a treated tumor).
  • Tumor cells had foamy vacuolated cytoplasm and pleomorphic nuclei (image A).
  • Benign prostate glands become atrophic with enlargement of the nuclei (but nuclear to cytoplasmic ratio remains the same).

Hormone therapy

    • Tumor composed of shrunken glands or single cells with small hyperchromatic or pyknotic nuclei and abundant clear (xanthomatous) cytoplasm. (may look like histocytes) (image B).
    • Because of the shrunken glands or single cells, sometimes the tumor is difficult to find in resections.
    • Benign prostate glands become atrophic; there is basal cell hyperplasia and urothelial metaplasia.

Remember – because of artifactual alteration; do not render a Gleason's grade on treated prostate cancer!