31st December 2024

Pathology of prostate cancer

The majority of prostate cancers are adenocarcinomas and arise in the outer zone of the prostate gland, where they are unlikely to produce urinary symptoms. Low-grade (Gleason 6) tumours are less likely to invade through the prostate capsule; high-grade (Gleason 8-10) tumours are more aggressive and more likely to invade through and metastasise. Spread is by direct invasion of the adjacent organs (seminal vesicles, bladder and rectum), infiltration of pelvic lymph nodes, and haematogenous spread to sites of distal metastasis. The most common site of metastasis is bone, where the classical picture is of osteoblastic or sclerotic metastases, although liver and lung may also be affected.