Anatomy of the anterior prostate and extraprostatic space: A contemporary surgical pathology analysis
Anatomy of the anterior prostate and extraprostatic space: A contemporary surgical pathology analysis
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DOI：
10.1097/pap.0b013e3181597a9c
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发表时间：
2007-11-01
影响因子：
6.7
通讯作者：
Reuter, Victor E.
中科院分区：
文献类型：
--
作者：
Fine, Samson W.;Al-Ahmadie, Hikmat A.;Reuter, Victor E.
25年前，麦克尼尔描述了一种基于不同平面的身体解剖的前列腺区解剖模型。与活体中看到的锥形器官不同，根治性前列腺癌切除标本通常是球形的，这是因为在手术切除和后续处理时组织收缩。从顶端到底端的切片产生了外科病理学“签出”的地形图，这可能与麦克尼尔的描述不同。目前还没有对前列腺前部解剖变异的深入研究，包括尿道周围区、外周(PZ)和移行区(TZ)、前纤维肌间质(AFMS)和前列腺外前间隙(EPS)。对197例完整提交的完整前列腺癌根治术标本的详细分析集中于从顶端到底部的分区解剖差异、AFMS与PZ和TZ的关系以及前部EPS的性质，揭示了可能对确定前部前列腺癌的分区起源和病理分期有重要影响的特征。这些观察包括顶端前PZ的主要性质及其与该位置AFMS的广泛接触的可能性，TZ在合并和非良性前列腺增生症的前列腺中的不同体积和位置，以及顶端前EPS的组成，包括脂肪组织、血管和顶端的骨骼肌，在底部包括中到大的平滑肌束。
Over 25 years ago, McNeal described a model of prostatic zonal anatomy based on autopsy dissections in various planes. As opposed to the cone-shaped organ seen in vivo, radical prostatectomy specimens are typically spherical, owing to tissue contraction at surgical removal and subsequent processing. Sectioning from apex to base yields topography at the Surgical Pathology "sign-out" that may vary from McNeal's descriptions. There are no in depth studies of anterior prostatic anatomic variability, including the periurethral region, peripheral (PZ) and transition (TZ) zones, anterior fibromuscular stroma (AFMS), and anterior extraprostatic space (EPS) using modern prosecting techniques. Detailed analysis of 197 entirely submitted, whole-mounted radical prostatectomy specimens focused on differences in zonal anatomy from apex through base, the relationship of AFMS to PZ and TZ, and the nature of the anterior EPS revealed features that may have significant impact on determination of zonal origin and pathologic staging of anteriorly situated prostate cancer. Among these observations are the predominant nature of the anterior PZ at the apex and the potential for its broad contact with the AFMS at this location, the differing volumes and location of the TZ in prostates with and without benign prostatic hyperplasia, and the composition of the anterior EPS, including adipose tissue, blood vessels, and skeletal muscle at the apex varying to include medium to large smooth muscle bundles at the base.