366
UNIT 3
Organ Systems
Accessory Genital Glands
Stroma
Stroma
Stroma
Lumen
Lumen
Lumen
Prostatic
Prostatic
concretions
concretions
Prostatic
concretions
A
Prostatic concretion
Prostatic concretion
(corpora amylacea)
(corpora amylacea)
Prostatic concretion
(corpora amylacea)
Lumen of the
Lumen of the
prostate gland
prostate gland
Lumen of the
prostate gland
Connective
Connective
tissue
tissue
Connective
tissue
Columnar
Columnar
epithelium
epithelium
Columnar
epithelium
B
Figure 18-20A.
Prostate gland.
H&E,
3
34
The
prostate gland
is similar to a chestnut in size and shape. It
surrounds the initial portion of the urinary urethra (
prostatic urethra
)
where the urethra exits the bladder. The prostate gland is penetrated
by two
ejaculatory ducts
and the
urethra
(Fig. 18-19A–C). It contains
many (about 30–50) highly
branched tubuloalveolar glands
(
com-
pound tubuloalveolar glands
). Each gland has a duct that empties its
products into the
prostatic urethra
. The mucosa of the prostate gland
is highly folded and is lined by simple columnar epithelium, which is
supported by a stroma (thin layer of connective tissue strands with
many smooth muscle cells). Here is an example of the prostate gland
with its characteristically irregular lumen that may contain
prostatic
concretions
. These concretions are also known as
corpora amylacea
and are more prominent in older men; they are composed of material
secreted by the prostate gland.
Figure 18-20B.
Prostate gland.
H&E,
3
272
A lumen in the
prostate gland
is shown housing a
prostatic concretion
(
corpora amylacea
). This is composed of calci±
ed prostatic secretions
that typically display concentric rings. These structures increase in
number with age. The secretion of the prostate gland contains
prote-
olytic enzymes
,
acid phosphatase
,
citric acid
,
f
brinolysin
, and
lipids
.
The epithelial cells are columnar in shape with basally located round
nuclei. The prostate gland produces secretions that empty into the ure-
thra to mix with
spermatozoa
and
seminal vesicle fl
uid
to form semen.
The prostatic secretion plays important roles in liquefying the coagu-
lated semen, helping to expel the spermatozoa, and increasing their
motility and survival rate after the semen has been transported into the
female reproductive tract.
CLINICAL CORRELATION
Figure 18-20C.
Prostate Cancer.
H&E,
3
96; inset
3
164
Prostate cancer
is the most common cancer in men and typically affects
men over the age of 50 years. It can be seen in younger men but is unusual
before the age of 40. The etiology of prostate cancer is elusive, but known
risk factors include a positive family history, African American race,
androgenic hormonal infl
uences, and environmental factors. The major-
ity of prostate cancers are adenocarcinomas arising from the glandular
component of the prostate. Patients may present with urinary symptoms,
such as dif± culty initiating or stopping the urine stream, or
dysuria
(pain
on urination). Other patients may ±
rst present with bone pain due to
advanced metastatic disease. Many patients are diagnosed with prostate
cancer through screening programs utilizing the digital rectal exam and
the serum
prostate-specif
c antigen (PSA) test
, and a needle biopsy if indi-
cated. Histologically, the appearance of prostate cancer is highly varied,
from
well-±ormed tubular structures
to individual in±
ltrating
malignant
cells
. Prostate cancers are graded histologically on the
Gleason system
,
from 1 (well differentiated) to 5 (poorly differentiated). Treatment of pros-
tate cancer may involve chemotherapy, hormonal manipulation, radiation
therapy (external beam and radioactive implants), or radical prostatectomy.
For some patients, particularly the elderly, watchful waiting may be a rea-
sonable alternative.
Note the prominent
nucleoli (malignant cells)
Prostate
cancer
C
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