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Obstructive urinary symptoms.
Prostatic adenocarcinoma is the most common cancer affecting men, especially those of older age. It most commonly arises in the posterior location of the peripheral zone which can be detected clinically through a digital rectal exam. As the name implies, adenocarcinoma forms glands. The cancerous glands are differentiated from benign glands in that they lack an outer basal cell layer which can be highlighted by immunohistochemical stains including high molecular weight cytokeratin, p63 and AMACR.
Prostatic adenocarcinoma is graded by Gleason score which assigns a grade from one to five based on architectural pattern. A total score composed of the most prevalent and second most prevalent architectural pattern is reported, with a maximum score of 10. A score of one is assigned to a well-circumscribed nodule while a maximum score of five is given to those lacking glandular differentiation. In this case, a score of 4+4 is given to this specimen as it is composed largely of glands that are not separated by stroma, forming a cribriform pattern.
Prostatic cancer can be found incidentally on TURP specimens and prostatectomy for other reasons such as resection for bladder cancer.