Cyto- and histomorphogenesis of the prostate carcinoma. A comparative light- and electron-microscopic study.

The fundamental histologic proliferation patterns of the prostate carcinoma are presented by the glandular and solid and/or cribriform structures. These were ultrastructurally analyzed from 28 carcinomas based on the cell forms in prostate carcinomas, which were already defined by electron microscope. These are characterized by their different cytoplasmic differentiation, whereby the singular cell types each represent a different functional state of a common tumor cell. The results indicate that the prostatic carcinoma develops morphologically in phases. The well-known growth patterns of the tumor are equivalent to its different states of development. In the first phase, a pattern develops out of a tumor stem cell (perhaps "primary atypical reserve cell"), which is either glandular or solid/cribriform, whereas this depends on the trend of the tumor cells to differentiate. The glandular structure possesses centrifugally proliferated glandular, often functionally deranged tumor cells, and shows signs of early stromal infiltration. The solid/cribriform pattern consists of centripetal proliferated, often less-differentiated tumor cells with or without lumen formation, and a peripheral layer of basal cells, whereby the idiopathic stroma architecture remains as it is. In the successive phase, stroma infiltration and destruction is distinctly marked durinaplastic" during tumor growth. Histologically, one often sees at this stage an "anaplastic" pattern; however, ultrastructurally its orign can be recognized as being glandular or solid/cribriform. The advanced stages of the tumor are furthermore characterized by a mixed cell pattern with all states of differentiation and by progressing tumor cell degeneration.