Histopathological spectrum of non-neoplastic and neoplastic prostate lesions and its association with high molecular weight cytokeratin (hmwck)

Of the diseases which affects the prostate the most frequently encountered lesions in clinical practice are benign prostatic hyperplasia, prostatitis and prostatic cancer (Cotran et al., 1994). Proliferative activity and invasiveness of prostatic glands increases from the benign to malignant end in the spectrum of prostatic lesions. For histopathological diagnosis, H&E (Hematoxylin and Eosin) staining is the gold standard. But sometimes on routine H&E staining prostatic lesions cause a diagnostic dilemma. In addition to routine staining, immunohistochemistry markers such as HMWCK play an important role in suspicious cases. The main aim of our study is to study the histopathological spectrum of prostatic biopsies and use of immunohistochemistry in addition to H & E staining in suspicious cases. This study was conducted in the Department of Pathology, AIMSR Bathinda, India on 146 biopsies. In our study 26.86% cases were neoplastic and 73.16% were non-neoplastic. The most common pattern seenin neoplastic lesions were ill defined glands and fused microacinar pattern. IHC was done on 60 suspicious cases. In 10 cases the diagnosis was changed on the basis of IHC marker (HMWCK). In 8 cases the diagnosis was changed from non- neoplastic to neoplastic whereas in 2 cases from neoplastic to non-neoplastic. From our study, we came to the conclusion that HMWCK marker should be strongly recommended in all suspicious areas in prostatic biopsies to remove any subjective error by a pathologist.