Question about Father's Biopsy Report

Check the PSA two weeks after the end of the antibiotics treatment to draw conclusions, however, the biopsy results so far are negative to cancer. The high PSA could be due to other causes, such as hyperplasia restricting urine flow that could be the cause of the pain.

I think you should inquire about the details of the biopsy from the urologist. What has he requested from the pathologist's laboratory? Was it to investigate for cancer or type of inflammation?

Pathologists use proper stains to identify malignancy if such is the purposes of the exam. For that extent urologists also label the cores according to the location of the samples, typically taken from 12 or 14 areas. The report above describes two bottles (left and right lobes) with no specifics on the samples. This is unusual and should be further investigated.

The samples can always be reused for additional staining, if necessary.

Please read this;

http://www.harvardprostateknowledge.org/understanding-your-prostate-pathology-report

Yes. The pathologist looks at the shape of the cells and assigns a Gleason score to what he sees. 

For instance, Gleason 3: not quite normal

Gleason 5: quite different from normal. 

Just giving examples here; my descriptions are not the 'official' ones that the pathologist uses! You can look up what Gleason 3 cells look like etc.

In the meeting with the doctors, I would start by inquiring about the purposes of the biopsy. Typically this involves the identification of the particulars existing/found in the tissue being analyzed. A complete work should include the identification of the type and shape of cells (commented by OldSalt), existing calculi, hyperplasia and any other particulars such as proteins. To do this work pathologists use immunohistochemistry (stains) and check all in a microscope. There are several ways to judge cancer. For instance, with the use of 34bE12 one manages to identify basal cells which are not existent in prostatic cancerous tissues. The high molecular weight cytokeratin 34bE12 reacts with human cytokeratin providing an image as a typical contrast does, therefore identifying basal cells. Etc, etc, etc.

Surely the pathologist is not analyzing the whole tissues of the prostate so that missing cancer is possible. To such extent, biopsies are done with established templates composed of 12 cores (or more) to check at 12 areas that are the most typical affected areas by cancer.

Best,

VG

Zent,

I read your entry at your newer thread on the AMACR Staining Test but I prefer to post here my comment as it follows other previous discussions on the same issue.

You wrote this;

           "If a prostate biopsy was negative in the pathology, had a positive staining for p 63 (Immunoreactive, score 4+ in all myoepithelial cells present in all glands), is an AMACR staining test required to rule out prostate cancer?" 

There are close to 25 types of prostate cancer many differentiated by their genes. Cancer is judged when comparing the type of cells, their shape, differentiation and any lack of particulars (components) against a normal cell of the same type. The staining is the quickest and standardized way to identify those differences. The process is complex due to the many variations and surely not a single stain can cover the whole process to a high degree of trust.

Accordingly, pathologists provide their views on a specimen in regards to what they see on the microscope. Surely the more stained the samples get the best the judgment can be done. A trustful test is the one that have been subjected to the full extent of a staining cocktail. It all depends on the efforts done by the pathologist to figure out a conclusion.

This leads many of us to get a second look into the specimen at a different laboratory, in particular when the case seems complex.

Best,

VGama