This book is intended to help pathologists survive when faced with prostate pathology problems. It provides a practical approach to common and rare diagnostic issues from the angle of experts in urologic pathology. The urologic pathology consult service at Johns Hopkins Hospital reviews approximately 12,000 second opinion consult cases annually, providing the authors a thorough understanding of the challenges that both general surgical pathologists and urologic pathologists encounter daily.
This textbook covers all the intricacies of diagnosing limited amounts of prostate adenocarcinoma, diagnostic pitfalls and the use of immunohistochemistry as an ancillary diagnostic tool. We have included comments on a host of newly available markers, highlighting their strengths and limitations. Prostate pathology has undergone significant changes in recent years, with changes to the grading scheme, recognition of new morphologic variants, as well as the utilization of prognostic biomarkers. The latter includinge PTEN expression and expression of mismatch repair proteins, used to categorize the risk of patients considering active surveillance or eligibility for therapy with immune check point inhibitors. The reader will find practical recommendations that are based on our real time approach to common problems in prostate pathology.
This is a concise but thorough guide to dealing with diagnostic challenges to ensure the best medical care for our patients.
Andres Matoso, MD
Jonathan Epstein, MD