The morphologic changes induced by hormone and radiation therapy on prostate carcinoma.

The morphologic changes induced by hormone and radiation therapy were evaluated in prostate biopsy and prostatectomy specimens from patients with residual prostate carcinoma. The two therapeutic methods induce changes both in the nonmalignant and malignant residual prostatic tissue. Following hormone therapy, the nonmalignant prostatic tissue showed atrophy of prostatic acini associated with fibrosis, basal cell hyperplasia, degenerative changes of the secretory epithelial cells, and a marked decrease of high-grade intraepithelial neoplasia (HGPIN). In the fragments of residual carcinoma, squamous cell metaplasia, necrosis, and necrobiosis in the foci, vacuolization of the cell cytoplasm, smaller, rare nucleoli, intraluminal crystalloids, higher Gleason score associated with a lower capsular penetration, areas of necrosis and mitoses were found. Following radiation therapy, the nontumoral prostatic tissue showed an increased number of atrophic acini, squamous cell metaplasia, and presence of atypical glands. The morphologic changes induced by radiation therapy in the residual prostatic carcinoma were characterized by an abnormal architectural structure of the glands and presence of cell atypias correlated with the biochemical lowering of serum PSA.