Pathological Assessment of Prostate Cancer

In the first instance, the diagnostic approach of prostate cancer (PCa) requires histopathological assessment of tumor tissue, and subsequent immunohistochemical analysis, if needed. In part I of this chapter, methods of PCa diagnosis based on differently obtained prostate tissue as well as essential information that have to be reported from pathologists are described. In addition, histomorphological basics for the diagnosis of PCa and, most importantly, features to differentiate PCa from non-neoplastic prostatic lesions are given. One of the most important information provided by pathologists is the current grading of PCa whose morphological basis is described in more detail. Part II summarizes immunohistochemical markers that are frequently used for diagnostic purposes and of potential prognostic value. In part III, the molecular signature of PCa is described by highlighting the most important characteristics of PCa including heterogeneity of primary PCa, genomic lesions affecting androgen receptor signaling and main changes during progression to metastatic disease.