The correct answer is D: Perineural invasion
Comment: Perineural invasion (PNI) was thought to be an accurate indicator of invasive capability of the cancer and considered an important risk factor. Recent analyses have suggested that PNI does not correspond with metastases. However, the question is still being debated in the literature.(Click here to see the whole slide image)
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1. Egan AJ, Bostwick DG. Prediction of extraprostatic extension of prostate cancer based on needle biopsy findings: perineural invasion lacks significance on multivariate analysis. Am J Surg Pathol. 1997 Dec;21(12):1496-500. PMID: 9414194
2. Masieri L, Lanciotti M, Nesi G, Lanzi F, Tosi N, Minervini A, Lapini A, Carini M, Serni S. Prognostic role of perineural invasion in 239 consecutive patients with pathologically organ-confined prostate cancer. Urol Int. 2010;85(4):396-400. Epub 2010 May 28. PMID: 20516669
3. Harnden P, Shelley MD, Clements H, Coles B, Tyndale-Biscoe RS, Naylor B, Mason MD. The prognostic significance of perineural invasion in prostatic cancer biopsies: a systematic review. Cancer. 2007 Jan 1;109(1):13-24. PMID:17123267