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sunflower
06-12-09, 06:09 PM
prostate

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The prostate gland, a conglomeration of 30 to 50 individual compound tubuloalveolar glands, is arranged in three discrete, concentric layers:
• Mucosal
• Submucosal
• Main

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1 - main prostatic glands
2 - stroma composed from smooth muscle cells and connective tissue
3 - stroma composed from smooth muscle cells and connective tissue
4 - fibro-elastic capsule
5 - prostatic part of the urethra
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According McNeal’s model of the prostate [7], four different anatomical zones may be distinguished that have anatomo-clinical correlation.
1) The peripheral zone : is the area forming the postero-inferior aspect of the gland and represents 70% of the prostatic volume. It is the zone where the majority (60-70%) of prostate cancers form.
2) The central zone : represents 25% of the prostate volume and contains the ejaculatory ducts. It is the zone which usually gives rise to inflammatory processes (eg prostatitis).
3) The transitional zone : this represents only 5% of the total prostatic volume. This is the zone where benign prostatic hypertrophy occurs and consists of two lateral lobes together with periurethral glands. Approximately 25% of prostatic adenocarcinomas also occur it this zone.
4) The anterior zone : predominantly fibromuscular with no glandular structures


Clinical colleration
1. Benign prostatic hyperplasia: the prostatic stroma and mucosal and submucosal glands  strangulates the lumen of the urethra  difficulty in urination.
95% 80-years-old men are afflicted.
2. Adenocarcinoma of the prostate: the cancer cells enter the circulatory system and metastasize to bone. It affects approximately 30% of men over 75 years of age.
- A simple blood test to detect prostatic-specific antigen (PSA) has been developed that permits early detection of prostatic adenocarcinoma. Although tumor growth can be detected by digital palpation through the rectum, a biopsy is required for confirmation.
- Surgery or radiotherapy are the usual treatments but they are not without possible side effects such as impotence and incontinence.
3. Corpora amylacea:The lumina of the tubuloalveolar glands frequently house round to oval prostatic concretions , composed of calcified glycoproteins, whose numbers increase with a person's age. The significance of these concretions is not understood.

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