By Roger S. Kirby MD FRCS(Urol) FEBU
It is a condensed model of the author's profitable Atlas of Prostatic Disease. The emphasis is on a succinct description of prostatic disorder in a mostly illustrative structure. The ebook covers the reasons, analysis and staging of prostate melanoma, benign prostatic hyperplasia and prostatitis. The sections on therapy were more advantageous by means of the addition of algorithms to summarize the decision-making method.
Men's overall healthiness is now a massive public health and wellbeing factor and prostatic sickness may have a big effect at the caliber of lifetime of many males. This publication will supply a handy precis for urologists, fundamental care physicians and nurse practitioners
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Extra resources for An illustrated pocketbook of prostatic diseases
52 AN ILLUSTRATED POCKETBOOK OF PROSTATIC DISEASES Figure 51 Clinical staging of prostate cancer: most prostate cancers develop in the peripheral zone and, when sufficiently large, become palpable as a T2 lesion. A T3 lesion denotes invasion of the prostatic capsule, and a T4 lesion often involves either the seminal vesicles or other adjacent structures AN ILLUSTRATED POCKETBOOK OF PROSTATIC DISEASES 53 Figure 52 Because many prostate cancers develop posteriorly in the peripheral zone of the gland, it is not surprising that tumor cells are often able to escape the confines of the gland through the veins and lymphatics that accompany the neurovascular bundles of Walsh Figure 53 An adenocarcinoma can be seen extending posterolaterally beyond the gland into adipose tissue to encircle the neighboring nerves and ganglia.
Chronic prostatitis may be bacterial or abacterial, but histological examination cannot distinguish between the two (Figure 40). Atrophy is a common sequel (Figure 41). Granulomatous prostatitis may also occur (Figure 42), but only occasionally is tuberculous prostatitis seen nowadays. Intravesical BCG (bacillus Calmette-Guérin) vaccine therapy may, on occasions, result in a granulomatous prostatitis (Figure 43). Figure 40 Prostatitis: an inflammatory infiltrate can be seen surrounding a duct or acinus and infiltrating the atrophic epithelium AN ILLUSTRATED POCKETBOOK OF PROSTATIC DISEASES 43 Figure 41 Atrophy: a shrunken lobule is associated with the presence of fibrosis and chronic inflammatory cells Figure 42 Granulomatous prostatitis: the distorted ulcerated ducts or acini are surrounded by a dense inflammatory infiltrate producing a nodular appearance at low power.
Loss of E-cadherin-staining in prostate cancer specimens appears to be strongly correlated with the subsequent development of metastases and is associated with a poor prognosis in prostate cancer patients. Angiogenesis factors For prostate cancer metastases to develop, tumor cells not only have to be released into lymphatics or the blood circulation, but cells must also have the ability to implant elsewhere and grow. Critical to this process is the ability of the developing metastases to induce their own blood supply—a process termed angiogenesis (Figure 22).