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TEST YOUR IMAGE IQ

Adenocarcinoma of the Prostate

By Robert D. Cardiff, MD, PhD | May 20, 2011

Professor of Pathology, Emeritus, Center for Comparative Medicine, University of California, Davis

This slide is from an elderly male with prostate cancer. He is thought to have a poor prognosis because of one feature in this slide (see arrow).

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)

Click here to view the comparative pathology.

This Image IQ has been provided by the Center for Genomic Pathology

References:

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

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Bone Metastases End-of-Life Care Palliative Care	Ethics in Oncology Practice Management Practice & Policy

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