The Archives of Pathology & Laboratory Medicine acknowledges the following individuals for volunteering to review abstract and case study submissions for the CAP17 meeting.

Pathologists are increasingly exposed to prostate biopsies with small atypical foci, requiring differentiation between adenocarcinoma, atypical small acinar proliferation suspicious for malignancy, and a benign diagnosis. We studied the level of agreement for such atypical foci among experts in urologic pathology and all-round reference pathologists of the European Randomized Screening study of Prostate Cancer (ERSPC). For this purpose, we retrieved 20 prostate biopsies with small (most <1 mm) atypical foci. Hematoxylin and eosin-stained slides, including 10 immunostained slides were digitalized for virtual microscopy. The lesional area was not marked. Five experts and 7 ERSPC pathologists examined the cases. Multirater kappa statistics was applied to determine agreement and significant differences between experts and ERSPC pathologists. The kappa value of experts (0.39; confidence interval, 0.29-0.49) was significantly higher than that of ERSPC pathologists (0.21; confidence interval, 0.14-0.27). Full (100%) agreement was reached by the 5 experts for 7 of 20 biopsies. Experts and ERSPC pathologists rendered diagnoses ranging from benign to adenocarcinoma on the same biopsy in 5 and 9 biopsies, respectively. Most of these lesions comprised between 2 and 5 atypical glands. The experts diagnosed adenocarcinoma (49%) more often than the ERSPC pathologists (32%) (P<0.001). As agreement was particularly poor for foci comprising <6 glands, we would encourage pathologists to obtain intercollegial consultation of a specialized pathologist for these lesions before a carcinoma diagnosis, whereas clinicians may consider to perform staging biopsies before engaging on deferred or definite therapy.

Journal of Men's HealthVol. 6, No. 3 WCMH AbstractsThe utility of PSA for detection of prostate cancer in men treated with dutasteride: Results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) study166G.L. Andriole, D. Bostwick, O. Brawley, L. Gomella, M. Marberger, F. Montorsi, C. Pettaway, T. Tammela, C. Teloken, D. Tindall, T.H. Wilson, M. Somerville, I. Fowler, and R.S. Rittmasteron behalf of the REDUCE Study GroupG.L. AndrioleWashington University School of Medicine in St. Louis, St. Louis, Missouri, USASearch for more papers by this author, D. BostwickBostwick Laboratories, Richmond, Virginia, USASearch for more papers by this author, O. BrawleyEmory School of Medicine, Emory University, Atlanta, Georgia, USASearch for more papers by this author, L. GomellaKimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USASearch for more papers by this author, M. MarbergerUniversity of Vienna, Vienna, AustriaSearch for more papers by this author, F. MontorsiUniversita Vita Salute San Raffaele, Milan, ItalySearch for more papers by this author, C. PettawayThe University of Texas, M. D. Anderson Cancer Center, Houston, Texas, USASearch for more papers by this author, T. TammelaDepartment of Urology, Tampere University Hospital, Tampere, FinlandSearch for more papers by this author, C. TelokenFundação Faculdade Federal de Ciências Médicas de Porto Alegre e Complexo Hospitalar Santa Casa, Porto Alegre, BrazilSearch for more papers by this author, D. TindallMayo Clinic, Rochester, Minnesota, USASearch for more papers by this author, T.H. WilsonGlaxoSmithKline, Research Triangle Park, North Carolina, USASearch for more papers by this author, M. SomervilleGlaxoSmithKline, Research Triangle Park, North Carolina, USASearch for more papers by this author, I. FowlerGlaxoSmithKline, Research Triangle Park, North Carolina, USASearch for more papers by this author, and R.S. Rittmasteron behalf of the REDUCE Study GroupGlaxoSmithKline, Research Triangle Park, North Carolina, USASearch for more papers by this authorPublished Online:21 Nov 2013https://doi.org/10.1016/j.jomh.2009.08.163AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"The utility of PSA for detection of prostate cancer in men treated with dutasteride: Results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) study." Journal of Men's Health, 6(3), p. 269FiguresReferencesRelatedDetailsCited byEffect of Dutasteride on Prostate Biopsy Rates and the Diagnosis of Prostate Cancer in Men with Lower Urinary Tract Symptoms and Enlarged Prostates in the Combination of Avodart and Tamsulosin TrialEuropean Urology, Vol. 59, No. 2CURRENT PROSPECTS FOR THE CHEMOPREVENTION OF PROSTATE CANCER26 August 2010 | BJU International, Vol. 106, No. 6 Volume 6Issue 3Sep 2009 InformationWPMH GmbHTo cite this article:G.L. Andriole, D. Bostwick, O. Brawley, L. Gomella, M. Marberger, F. Montorsi, C. Pettaway, T. Tammela, C. Teloken, D. Tindall, T.H. Wilson, M. Somerville, I. Fowler, R.S. Rittmaster, and on behalf of the REDUCE Study Group.The utility of PSA for detection of prostate cancer in men treated with dutasteride: Results from the REduction by DUtasteride of prostate Cancer Events (REDUCE) study.Journal of Men's Health.Sep 2009.269-269.http://doi.org/10.1016/j.jomh.2009.08.163Published in Volume: 6 Issue 3: November 21, 2013PDF download

BACKGROUND. As dihydrotestosterone (DHT) is the most potent androgen in the prostate, inhibition of the 5 alpha-reductase isoenzymes, which convert testosterone to DHT, could be an appropriate target for the treatment of prostate cancer.METHODS. Eighty-one men with clinically localized prostate cancer received daily dutasteride 3.5 or 0.5 mg, or no therapy for 4 months before radical prostatectomy. Histopathological assessments were conducted on prostatectomy specimens.RESULTS. Treatment with dutasteride was associated with reductions in serum and intraprostatic DHT of >= 90%, and a decrease in total prostate and tumor volumes. No effect of dutasteride was noted on Gleason grade. Histopathological effects on benign tissue were similar but less prominent than those seen with androgen ablation, whereas there was no significant difference in cancer histology among the groups.CONCLUSIONS. Dutasteride treatment results in similar but less marked changes compared with androgen ablation.

M. Gleave,* J. Qian, C. Andreou, P. Pommerville, J. Chin, R. Casey, G. Steinhoff, N. Fleshner, D. Bostwick, L. Thomas, and R. Rittmaster on behalf of the ARI40010 Study Team Prostate Centreat VancouverGeneralHospital,Vancouver, British Columbia,Canada Bostwick Laboratories, Inc.,Glen Allen,Virginia SurreyMemorialHospital, Surrey,British Columbia,Canada Can-MedClinical Research, Inc.,Victoria,British Columbia,Canada LondonHealth Sciences Centre, London,Ontario,Canada The Female/MaleHealthCentre,Oakville,Ontario,Canada Dr.Steinhoff Clinical Research,Victoria,British Columbia,Canada DivisionofUrology, PrincessMargaretHospital,Toronto,Ontario,Canada Departmentof BiochemistryandMolecular Biology,DalhousieUniversity,Halifax,Nova Scotia,Canada ResearchandDevelopment,GlaxoSmithKline, ResearchTriangle Park,NorthCarolina

M. Gleave,* J. Qian, C. Andreou, P. Pommerville, J. Chin, R. Casey, G. Steinhoff, N. Fleshner, D. Bostwick, L. Thomas, and R. Rittmaster on behalf of the ARI40010 Study Team Prostate Centreat VancouverGeneralHospital,Vancouver, British Columbia,Canada Bostwick Laboratories, Inc.,Glen Allen,Virginia SurreyMemorialHospital, Surrey,British Columbia,Canada Can-MedClinical Research, Inc.,Victoria,British Columbia,Canada LondonHealth Sciences Centre, London,Ontario,Canada The Female/MaleHealthCentre,Oakville,Ontario,Canada Dr.Steinhoff Clinical Research,Victoria,British Columbia,Canada DivisionofUrology, PrincessMargaretHospital,Toronto,Ontario,Canada Departmentof BiochemistryandMolecular Biology,DalhousieUniversity,Halifax,Nova Scotia,Canada ResearchandDevelopment,GlaxoSmithKline, ResearchTriangle Park,NorthCarolina

Purpose: The Prostate Cancer Prevention Trial (PCPT) showed that the 5 alpha-reductase inhibitor (5ARI) finasteride significantly decreased the 7-year period prevalence of prostate cancer vs placebo. However, Gleason score 7-10 tumors were significantly more common in the finasteride vs the placebo group. We considered data on the effects of 5ARIs on prostate cancer natural history and detection.Materials and Methods: A detailed review was performed of the literature identified from the MEDLINE database examining the effects of 5ARIs on prostate cancer prevalence and tumor histopathology.Results: In PCPT there were fewer biopsies performed for cause in the finasteride vs the placebo group and the proportion of high grade tumors in the treatment groups did not diverge with time. Given that finasteride has an effect on prostate specific antigen and prostate volume, which are key factors in triggering prostate biopsies, they may be significant confounders of Gleason score results. Prostate shrinkage in the finasteride treated group may minimize biopsy sampling error. Furthermore, histological studies have shown that 5ARIs have a significant effect on prostate architecture, which can make the interpretation of prostate specimens in men treated with 5ARIs difficult. Further evaluation of PCPT findings will help determine the true nature of these observations.Conclusions: 5ARIs decrease the risk of prostate cancer but also alter the detection of disease through effects on prostate specific antigen, and prostate volume and histology. The weight of evidence suggests an artifactual effect of finasteride on Gleason grading in the PCPT. The role of 5ARIs for prostate cancer chemoprevention needs further examination before it can be considered for wide recommendation.

We report the clinical and pathologic features of 2 cases of pleomorphic giant cell carcinoma of the prostate. One case was found at autopsy in a 77-year-old man and was composed of high-grade prostatic adenocarcinoma with prominent anaplastic giant cells. The patient presented with metastases to multiple retroperitoneal lymph nodes, liver, and lumbar vertebrae. The second case occurred in a 45-year-old man who underwent transurethral resection of the prostate and was found to have high-grade prostatic adenocarcinoma with an extensive anaplastic giant cell component. The patient presented with distant metastases and died within 9 months. Both regular adenocarcinoma and anaplastic giant tumor cells displayed cytoplasmic immunoreactivity for prostate-specific antigen, prostatic acid phosphatase, and keratin AE1/AE3; in one case, scattered cells were also positive for chromogranin and epithelial membrane antigen. Pleomorphic giant cell carcinoma is a rare variant of prostatic adenocarcinoma with a poor prognosis that should be considered in the differential diagnosis of prostatic pleomorphic tumors.

You have accessJournal of UrologyModerated Poster, Wednesday, May 25, 2005, 3:30 - 5:30 pm1 Apr 20051669: Is High-Grade Prostatic Intraepithelial Neoplasia (PIN) More Frequent than Previously Estimated? David Bostwick, Barry S. Stein, Ron S. Israeli, Eric T. Goluboff, K.G. Barnette, and Mitchell S. Steiner David BostwickDavid Bostwick More articles by this author , Barry S. SteinBarry S. Stein More articles by this author , Ron S. IsraeliRon S. Israeli More articles by this author , Eric T. GoluboffEric T. Goluboff More articles by this author , K.G. BarnetteK.G. Barnette More articles by this author , and Mitchell S. SteinerMitchell S. Steiner More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)35791-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1669: Is High-Grade Prostatic Intraepithelial Neoplasia (PIN) More Frequent than Previously Estimated?." The Journal of Urology, 173(4S), pp. 452–453 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 173Issue 4SApril 2005Page: 452-453 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information David Bostwick More articles by this author Barry S. Stein More articles by this author Ron S. Israeli More articles by this author Eric T. Goluboff More articles by this author K.G. Barnette More articles by this author Mitchell S. Steiner More articles by this author Expand All Advertisement Loading ...

You have accessJournal of UrologyDiscussed Poster, Sunday, May 9, 2004, 8:00 am - 12:00 pm1 Apr 2004284: Monitoring Superficial Bladder Cancer (BC) with the Immunocyt Fluorescent Cytology Test Edward M. Messing, Howard Korman, Edward Barker, Jeanne Underhill, Lisa Teot, and David Bostwick Edward M. MessingEdward M. Messing More articles by this author , Howard KormanHoward Korman More articles by this author , Edward BarkerEdward Barker More articles by this author , Jeanne UnderhillJeanne Underhill More articles by this author , Lisa TeotLisa Teot More articles by this author , and David BostwickDavid Bostwick More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)37546-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "284: Monitoring Superficial Bladder Cancer (BC) with the Immunocyt Fluorescent Cytology Test." The Journal of Urology, 171(4S), pp. 74–75 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 74-75 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Edward M. Messing More articles by this author Howard Korman More articles by this author Edward Barker More articles by this author Jeanne Underhill More articles by this author Lisa Teot More articles by this author David Bostwick More articles by this author Expand All Advertisement Loading ...

The full potential of knowledge based systems will be realized only when users who are not knowledge engineers are able to easily develop and deploy the underlying knowledge bases. To this end we are developing a system for rapid knowledge base design that permits such users to populate knowledge bases. The system provides a wizard style interface that is configurable for specific knowledge acquisition tasks. Supporting this system is an efficient knowledge representation system that provides frame system semantics and sophisticated constraint reasoning.

Purpose: Chemoprevention may significantly impact the natural history of prostate cancer. The most potent intraprostatic androgen, dihydrotestosterone, has a significant role in the pathophysiology of prostate cancer. It represents a biologically plausible target for chemoprevention through the inhibition of 5alpha-reductase isoenzymes.Materials and Methods: The Reduction by Dutasteride of Prostate Cancer Events clinical trial is an international, multicenter, double-blind, placebo controlled chemoprevention study designed to determine if dutasteride 0.5 mg daily decreases the risk of biopsy detectable prostate cancer. A total of 8,000 men will be randomized to receive dutasteride or placebo for 4 years. Eligible men must be 50 to 75 years old, have a serum prostate specific antigen of 2.5 to 10 ng/ml (ages 50 to 60 years) or 3.0 to 10 ng/ml (older than 60 years). Men must have a negative 6 to 12 core biopsy within 6 months prior to enrollment. Repeat biopsies will be taken at 2 and 4 years. The rates of prostate cancer for each treatment group will be compared. Genetic and protein biomarkers of prostate cancer, and the effect of dutasteride on benign prostatic hyperplasia and prostatitis symptomatology and histopathology will also be assessed.Results: Results remain to be determined.Conclusions: The study will examine the effects of the dual 5alpha-reductase inhibitor dutasteride on the natural history of prostate cancer in men at increased risk for this malignancy. It affords a unique opportunity to examine biomarkers and genetic linkage for prostate cancer, and assess a range of prostate health outcome measures.

BACKGROUND AND PURPOSE Endopyelotomy is the preferred treatment for ureteropelvic junction (UPJ) obstruction because of its short operating time, limited morbidity, fast recovery, and reasonable efficacy. We used tissue and immunohistochemistry staining and electron microscopy to look at the muscle regeneration following an endopyelotomy incision in a porcine model. MATERIALS AND METHODS Bilateral electrosurgical endopyelotomy was performed in six domestic pigs with placement of 7F 20-cm Percuflex double-J stents for up to 4 weeks, and urinary tracts were harvested at 3 or 5 months. Specimen evaluation included tissue staining with hematoxylin-eosin, Masson's trichrome, and Verhoeff's iodine and Van Gieson solution; histochemical staining for smooth-muscle actin, desmin and myosin staining, and electron microscopy. Each specimen was assigned a "healing" score of 0 (normal) 1 (slight changes), 2 (mild changes), or 3 (severe changes). The fibrosis score was based on six factors: muscle layer fibrosis, lamina propria fibrosis, amount of granulation tissue present, new deposits of collagen, fibrosis in the periureteral fat, and presence of myofibroblasts. The muscles were characterized with immunohistochemistry and electron microscopy. RESULTS At both 3 and 5 months, the urothelium was healed, and the lamina propria was healed with focal loss. By 3 months, smooth-muscle bundles bridged the defect, and by 5 months, the whole defect was covered. Smooth muscle cells were evident by electron microscopy by 3 months, and actin and myosin could be detected by immunohistochemistry. Desmin-positive cells accounted for 50% of the population at 3 months and 40% at 5 months. The regenerated smooth-muscle bundles were oriented in different directions and intermingled with fibrous tissue. They could be distinguished easily from normal ureter under the microscope. CONCLUSION Verifiable, functional smooth-muscle bundles bridge the endopyelotomy defect by 3 months, as confirmed by immunohistochemistry staining and electron microscopy.