Characteristics of hormone-treated prostate carcinoma: Stressing the need for clinician-pathologist communication

Objective: Patients scheduled for prostatectomy often receive androgen depr ivation therapy to make malignant tumors more amenable to resection and imp rove the postoperative course. These hormonal therapies may significantly a lter the histomorphology of carcinoma of the prostate detected on subsequen t needle biopsies. Methods: Needle specimens were obtained from resected pr ostates harboring biopsy-proven carcinoma previously treated with leuprolid e, The tissue was examined by light microscopy to note architectural and cy tologic characteristics. Results: A high proportion of treated carcinomas h ad an atrophic, infiltrative appearance. Nuclear and nucleolar enlargement were consistently observed. Macronucleoli, blue-tinged mucin, and intralumi nal pink amorphous material was frequently identified. Conclusions: The mar kedly atrophic nature of the cells and glands may result in either overgrad ing of prostate carcinoma or failure to recognize the more subtle patterns of this malignant neoplasm. It is imperative that clinicians convey a histo ry of hormone treatment to pathologists when core biopsies of the prostate are submitted for histologic evaluation.