Assessment of histopathological features of needle biopsy in recurrent prostate cancer following salvage high-intensity focused ultrasound

Authors

  • Michele Billia Department of Surgery, Division of Urologic Oncology, London Health Sciences Centre, Western University, London
  • Khurram M. Siddiqui Department of Surgery, Division of Urologic Oncology, London Health Sciences Centre, Western University, London
  • Susanne Chan Department of Pathology and Laboratory Medicine, London Health Sciences Centre, Western University, London
  • Fan Li Department of Surgery, Division of Urologic Oncology, London Health Sciences Centre, Western University, London
  • Ali Al-Zahrani Department of Urology, University of Dammam, Dammam
  • Jose A. Gomez Department of Pathology and Laboratory Medicine, London Health Sciences Centre, Western University, London
  • Joseph L. Chin Department of Surgery, Division of Urologic Oncology, London Health Sciences Centre, Western University, London

DOI:

https://doi.org/10.5489/cuaj.3918

Abstract

Introduction: Local recurrence of prostate cancer (PCa) following radiotherapy may be treated with curative intent using salvage highintensity focused ultrasound (s-HIFU). The interpretation of needle core biopsy specimens following s-HIFU is a daunting task, even for experienced pathologists. We describe various histopathological features encountered in biopsy specimens following whole-gland s-HIFU in one of the largest descriptive studies to date.

Methods: Fifty-five patients with biopsy-proven localized radiorecurrent PCa underwent s-HIFU and transrectal ultrasound (TRUS)- guided prostatic needle biopsies at 180 days post-treatment. All biopsies were reviewed by two genitourinary pathologists.

Results: PCa was detected in 11 (24%) biopsies. Radiation therapyassociated changes were identified in all cases. Additional findings included extensive coagulative stromal necrosis (100%), smudgy chromatin of cancer nuclei (82%), and markedly enlarged bizarre nuclei in the residual cancer (55%). Gleason grade assignment was possible in 10 (91%) of these biopsies and concordance of Gleason grading between pre- and post-therapy specimens was observed in six (60%) cases.

Conclusions: The histological interpretation of needle biopsies following salvage HIFU is challenging and requires an understanding of the histopathological changes associated with this procedure in both tumoural and non-tumoural prostatic tissue. Accurate interpretation of the morphological changes following s-HIFU is instrumental for optimization of clinical decision-making and treatment planning in recurrent PCa.

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Author Biography

Khurram M. Siddiqui, Department of Surgery, Division of Urologic Oncology, London Health Sciences Centre, Western University, London

Urologic Oncology Fellow

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Published

2016-12-15

How to Cite

Billia, M., Siddiqui, K. M., Chan, S., Li, F., Al-Zahrani, A., Gomez, J. A., & Chin, J. L. (2016). Assessment of histopathological features of needle biopsy in recurrent prostate cancer following salvage high-intensity focused ultrasound. Canadian Urological Association Journal, 10(11-12), 416–22. https://doi.org/10.5489/cuaj.3918

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Section

Original Research