Histology of the Prostate in Elderly Men

As part of a comprehensive study of the testes, the pituitary gland and the adrenal glands in relation to abnormal growth of the prostate, the occurrence of benign nodular hyperplasia (BNH), carcinoma (C), diffuse atrophy (DA) and normal histology (N) of the prostate was studied in a consecutive series of 206 men over 40 years of age submitted to necropsy. Atypical glands without obvious invasive properties were recorded separately and termed atypical glandular proliferation (AGP). The occurrence of BNH and C were both strongly related to age. BNH was the most frequent histological pattern encountered (80.1 per cent), and after the age of 70 years, BNH was observed in practically all cases. C was observed in 70 patients (34 per cent) and was an incidental finding at autopsy in all but four cases. After the age of 80 years, 52 per cent carried C. The great majority of carcinomas were small and were located predominantly in the peripheral zone of the prostate. The frequency of C in patients previously operated upon for BNH was similar to that in non‐operated patients. The frequency of BNH in prostates with C was not different from that to be expected as a purely coincidental occurrence. The location of AGP resembled that observed for C. However, the simultaneous occurrence of AGP and BNH was more frequent than that to be expected as pure coincidence. Whether AGP represents benign or potentially malignant lesions remains obscure. The classification of AGP as a benign lesion or carcinoma may markedly influence the prevalence ratios of latent prostatic carcinoma in autopsy series. In patients dying from cardiovascular disease, BNH occurred more frequently, and C less frequently, than what would be expected.