Objective:

It is known that incidental prostate cancer (IPCa) can be seen in a low possibility for patients who were performed transurethral resection of the prostate (TURP) due to bladder outlet obstruction and/or prostatism symptoms. These materials are usually sent to pathology laboratory with the prediagnosis of benign prostatic hyperplasia (BPH). In this study, it was aimed to determine histopathological parameters accompanying IPCa in the prediagnosis of BPH materials that is obtained by TURP.

Materials and Methods:

Prostate tissues of 1.315 people who applied for bladder outlet obstruction or prostatism symptoms and in whom TURP was performed in Üsküdar State Hospital between the years 2006-2015 were evaluated. Thirty one patients who were diagnosed with IPCa were included in this study and 149 patients with BPH were included as a control group by systematic sampling. The degree of presence of inflammation, whether the inflammation is acute or chronic, atrophy, adenosis, presence of prostatic intraepithelial neoplasia (PIN), basal cell hyperplasia, stromal nodules, presences of granuloma and mucinous/squamous metaplasia were evaluated in all slides.

Results:

The inflammation incidence in patients who were diagnosed with IPCa was 41.9%, while the incidence was 73.2% in patients with BPH. While the inflammation rate was significantly higher in BPH than that in the IPCa (p<0.01), no difference was found between the mild, moderate and severe degrees of inflammation. Low grade PIN was seen in 9 (29%) patients with IPCa and high grade PIN was seen in 9 (29%) patients. All 13 patients with PIN in BPH were low grade. Stromal nodule rate in patients diagnosed with IPCa was 48.4%, while the incidence was 12.8% in patients with BPH; the difference was significantly higher (p<0.01).

Conclusion:

PIN and stromal nodules are often accompanied by IPCa. Detection of PIN and stromal nodules in TURP materials with BPH prediagnosis, should guide the physician for histopathological evaluation of the remaining material.

Keywords: Incidental prostate cancer, histopathological parameters, stromal nodules