|dc.description.abstract||Introduction: The main diseases of the prostate are prostatitis, benign prostatic
hypertrophy and prostate cancer. One in ten men will develop clinically significant
prostate cancer in their lifetime. Men who are diagnosed in their 50s and 60s
probably started to develop the disease in their 30s and 40s. Prostatic
Intraepithelial Neoplasia has been associated with prostate cancer on
epidemiologic, clinical, genetic, and molecular levels .
Objective: To determine the prevalence of carcinoma of the prostate, high grade
prostatic intraepithelial neoplasia (HGPIN), low grade prostatic intraepithelial
neoplasia (LGPIN),benign prostatic hyperplasia, atypical adenomatous
hyperplasia, squamous metaplasia and prostatitis in autopsy prostate specimens
and compare the findings with those from other geographical areas.
Design: Descriptive cross-sectional study conducted from November 2006 to
Setting: The KNH mausoleum, the City Mortuary, Nairobi and the histopathology
laboratory, University of Nairobi.
Subjects: One hundred and three prostates removed at autopsy from men aged
twenty years and above who were not known to have prostate pathology. All the
subjects were black Africans.
Methods: A total of 103 prostatic gland specimens were examined by standard
histopathological methods. The glands were fixed in 10% formalin, weighed,
sliced at 2-4mm intervals from the apex to the bladder base and then paraffin
The paraffin blocks were sectioned with a microtome to 5urn sections that were
mounted on microscopic slides. The histological slides were stained with
haematoxylin and eosin. They were then examined by the principal investigator
and the diagnoses confirmed by the supervisor. Another pathologist
counterchecked some of the slides.
Outcome measures: Age, prostate weights, benign prostatic hypertrophy, atypical
adenomatous hyperplasia, squamous metaplasia, prostatitis, corpora amylacea, low
grade prostatic intraepithelial neoplasia, high grade prostatic intraepithelial
neoplasia, prostatic carcinoma.
Results: All the 103 prostate gland specimens were processed and the histological
results analyzed using the SSPS software. The average weight of all the specimens
was 27.8 grammes. Four of the specimens were more than 40 grammes.
Microscopy showed that 31.1% were essentially normal, 29.1% had chronic
prostatitis, 27.2% microscopic hyperplasia, 23.3% LGPIN, 15.5%HGPIN, 10.7%
atypical adenomatous hyperplasia, 1% prostate carcinoma in a 48 year old, 7.8%
squamous metaplasia. Corpora amylacea was seen in 25.2% of the specimens. The
mean prostate weights increased with age. Microscopic benign prostatic
hyperplasia increased from 15..8% in the fourth decade to 80% in the seventh
decade. Low grade prostatic intraepithelial neoplasia was 24% in the third decade,
increasing to 28.6% in the fifth decade. High grade prostatic intraepithelial
neoplasia was 4% in the third decade, increasing to 40% in the seventh decade.
Conclusion: Premalignant lesions of the prostate are common in black Africans.
The prevalence of incidental carcinoma was very low in this study. Benign
prostatic hyperplasia starts early and increases with age. Chronic prostatitis was
common in all age groups and it did not follow a particular pattern. Corpora
amylacea was seen in all age brackets.||en