The fifth edition of the Biopsy Interpretation of the Prostate brings the field of prostate pathology up to date since the last edition published in 2008. The new edition covers new immunohistochemical markers used for the diagnosis of prostate cancer and its distinction from mimickers. Expanded sections cover common and rare pitfalls of immunohistochemistry in the diagnosis of adenocarcinoma of the prostate. New entities such as fibromyxoid nephrogenic adenoma, high-grade foamy gland carcinoma, new variants of ductal adenocarcinoma and high-grade prostatic intraepi-thelial neoplasia (PIN), and prostate cancer with aberrant p63 expression are covered. Lesions that were just being introduced in the fourth edition, such as intraductal carcinoma, PIN-like ductal carcinoma, and variants of stromal tumors of the prostate, are now discussed more thoroughly. The fifth edition updates the correlation of needle biopsy carcinoma grade and extent, atypical findings suspicious for carcinoma, and PIN with results at radical prostatectomy. Since the fourth edition, there have been further significant modifications to the Gleason grading system. The current edition covers these changes in detail along with an increased discussion as to how grade impacts clinical decisions. The chapter on neuroendo-crine differentiation in the prostate has been totally reworked to reflect the recent consensus conference on this topic. Finally, the fifth edition updates the molecular findings of prostate cancer and how it may affect therapy and predicting prognosis. Jonathan I. Epstein, MD.,George J. Netto, MD

Preface vi

Preface to the First Edition vii

1 Clinical Correlates with Biopsy: Serum Prostate-Specific Antigen, Digital Rectal Examination, and Imaging Techniques 1

2 Needle Biopsy Technique, Tissue Sampling, and Processing of Needle Biopsy and Transurethral Resection Specimens 8

3 Gross Anatomy and Normal Histology 16

4 Inflammatory Conditions 25

5 Preneoplastic Lesions in the Prostate: Prostatic Intraepithelial Neoplasia and Intraductal Carcinoma of the Prostate 38

6 Diagnosis of Limited Adenocarcinoma of the Prostate 83

7 Mimickers of Adenocarcinoma of the Prostate 130

8 Reporting Cancer: Influence on Prognosis and Treatment 185

9 Grading of Prostatic Adenocarcinomas 202

10 Findings of Atypical Glands Suspicious for Cancer 235

11 Prostatic Duct Adenocarcinoma 254

12 Neuroendocrine Differentiation in the Benign and Malignant Prostate 268

13 Mucinous Differentiation in the Benign and Malignant Prostate 291

14 Benign and Malignant Prostate following Treatment 298

15 Urothelial Carcinoma 314

16 Mesenchymal Tumors and Tumor-like Conditions 333

17 Miscellaneous Benign and Malignant Lesions 355

18 Prostatic Urethral Lesions 377

19 Emerging Biomarkers for Detection and Management of Prostate Carcinoma 392

Appendix: Macros 411

Index 418

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