The Open Pathology Journal

2009, 3 : 64-73
Published online 2009 August 29. DOI: 10.2174/1874375700903010064
Publisher ID: TOPATJ-3-64

Effect of Radiotherapy on Non-Neoplastic and Malignant Prostate

Kenneth A. Iczkowski
Department of Pathology, University of Colorado Health Science Center, P.O. Box 6511, Campus Mail Stop 8104, Aurora, CO 80010, USA

ABSTRACT

Pathologists nowadays are frequently confronted with post-radiotherapy biopsies of the prostate. It is critical to recognize the changes of benign prostatic tissue with radiation effect, which include frequent acinar atrophy, acinar distortion, basal cell hyperplasia, decreased acinar/stromal ratio, and stromal fibrosis. The non-neoplastic irradiated prostate can have nuclear enlargement and bizarre nuclei, changes overlapping or exceeding those commonly seen in prostatic adenocarcinoma. The presence of high-grade PIN adjacent to acini in question favors a cancer diagnosis. Ceratin immunostains, particularly cytokeratin 34ßE12, in conjunction with selected other markers, can help the pathologist determine whether residual cancer is present in the most difficult cases.

Keywords:

Irradiation, therapy-induced changes, prostate, biopsy, immunohistochemistry. .