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Authors: John Maksem, MD 

Orlando Health Orlando Regional Medical Center, Department of Pathology, Orlando, FL 32806.

FOREWARD:

In this presentation, we have built upon and extended a data set that we originally assembled to analyze and translate Gleason histology grading into patterns useful for grading prostate cytology preparations as obtained from fine needle aspirations of the prostate gland [1]. This expanded data set, again of matched biopsy/cytology pairs was finalized in early 1988, but outside of its passing mention in the “Urologic Clinics of North America” [2], our findings were never officially published. The latter study involved a collaborative effort involving myself (now retired), the acclaimed urologic pathologist—Dr. Myron Tannenbaum (now deceased), and the originator of Gleason grading—Dr. Donald Gleason (now deceased). The study encompassed biopsy-to-cytology correlations (obtained from the same cores of prostate sextant biopsies that were collected into a polyfunctional fixative and processed, simultaneously, as hematoxylin and eosin histology slides and cytocentrifuge cytology slides). It comprised prostate cancer cases from 302 men. Because of recent changes in prostate histology pattern assignment and grading generally accepted by the International Society of Urological Pathology (ISUP; born of a consensus meeting for grading of prostatic carcinoma held in September 2019, in Nice, France), I have retrofitted our otherwise unpublished observations into patterns proposed by the ISUP grading system [3] with the purpose of representing ISUP prostate tissue patterns as they would appear in matched cytological preparations if they were collected today. It is our goal to show how prostate cytology can still have relevancy to today’s practice of urological cytopathology. What follows, rather than a strictly scientific study, is a historical vignette regarding past successes with fine needle aspiration biopsy of the prostate that is accompanied by a “picture book” or “mini atlas” of cytology images meant to show today’s cytopathologists just how much can be seen with a simple, readily available and cost-effective technique. It is also my hope to encourage the continued exposure of pathology residents and cytopathology fellows to FNA prostate cytology and not to banish a practice that once dominated prostate cancer diagnosis to “a dustbin of now-ignored methodologies”.

Citation:

John Maksem, MD. RE-EXAMINING PROSTATE FINE NEEDLE ASPIRATION BIOPSY IN THE 21ST CENTURY: CANCER CYTOLOGY PATTERNS AS SEEN WITH ISUP GRADING OF PROSTATIC CARCINOMA.. Annals of Urology 2024.