acid-phosphatase and Cystitis

Cystitis cystica (CC) and cystitis glandularis (CG) are common in the urothelium lining the bladder neck and trigone. Because some cases of CG show histologic features strikingly similar to prostatic acini, we hypothesized that some such foci may represent prostatelike metaplasia in the urinary bladder. Forty surgical and autopsy bladder specimens (23 males, 17 females) showing CC or CG were studied using anti-prostate specific antigen and anti-prostate specific acid phosphatase antibodies. Fourteen (35%) of these 40 cases showed positive staining for prostate specific antigen or prostate specific acid phosphatase or both in CC or CG foci. Among these were five female patients. The findings indicate that bladder epithelium is capable of undergoing prostatelike metaplasia and lend support to the hypothesis that the adult bladder stroma closest to the prostate may exert inductive influences on the overlying epithelium to show prostatelike metaplasia.

Topics: Acid Phosphatase; Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Autopsy; Biopsy; Cystitis; Epithelium; Female; Humans; Male; Metaplasia; Middle Aged; Prostate-Specific Antigen

We retrospectively reviewed records of 551 patients with clinical Stage C prostatic adenocarcinoma treated with 60 to 70 Gy external beam radiation. Elective pelvic node irradiation was given to 247 patients (45%). Follow-up for all surviving patients ranged from 16 to 201 months (median, 6.5 years; mean, 7 years). The 5-, 10-, and 15-year uncorrected actuarial survival rates were 72%, 47%, and 27%, respectively. Disease-free survival rates were 59%, 46%, and 40% at the corresponding times. Actuarial local control rates were 88%, 81%, and 75% at 5, 10, and 15 years, respectively. Disease-free survival was adversely affected by high pathologic grade, disease fixed to the pelvic sidewall, invasion of the bladder, prior transurethral resection, hydronephrosis, and elevated serum levels of prostatic acid phosphatase and creatinine. Elective pelvic node irradiation did not improve the outcome. Complications of treatment were acceptable: minor anorectal and/or urinary symptoms, 11%; mild to moderate complications, 19%; serious problems requiring surgery, 3%. It is concluded that localized, high-energy external beam irradiation provides excellent local control of disease, low morbidity, and 5-, 10-, and 15-year survival rates that have not been rivaled by other treatment.

Topics: Acid Phosphatase; Adenocarcinoma; Aged; Creatinine; Cystitis; Hematuria; Humans; Male; Middle Aged; Neoplasm Metastasis; Pelvic Neoplasms; Proctitis; Prognosis; Prostatic Neoplasms; Radiotherapy, High-Energy; Retrospective Studies; Urination

Variation in serum prostatic acid phosphatase (PAP) level over a twenty-four-hour period was studied in 18 urologic patients with no prostatic disease. Hourly, twenty-four-hour serum PAP level was determined using Elisa method. Seven of 18 patients (38.8%) showed appreciable change with definite diurnal pattern. PAP level was highest in early AM hours and lowest in the PM period. The difference between the mean AM and PM periods was statistically significant (P less than 0.01). Four of 18 patients showed no change over the twenty-four hours while 7 patients showed some variation without definite diurnal pattern. Such changes may lead to variation in serum PAP level and may lead to false positive results.

Topics: Acid Phosphatase; Adult; Aged; Circadian Rhythm; Clinical Enzyme Tests; Cystitis; Enzyme-Linked Immunosorbent Assay; Humans; Male; Middle Aged; Prostate; Schistosomiasis haematobia; Urethral Stricture; Urinary Calculi; Urologic Diseases

The clinicohistologic features of seven urethral and four urinary bladder polyps with prostatic-type epithelium are described. The average age of the patients was 50 years. Seven patients had prior cystoscopies and in none of them was the lesion noted initially. Histologically the lesions were papillary or polypoid and the surface was lined predominantly by prostatic-type epithelium with interspersed transitional epithelial cells or by transitional epithelium with interspersed prostatic-type epithelial cells. The prostatic-type columnar cells contained foamy, faintly eosinophilic cytoplasm, which stained strongly for prostate specific antigen and prostatic acid phosphatase. In all the lesions, there were prostatic acini in the underlying fibrovascular stroma, which was devoid of smooth muscle. The intermingling of prostatic-type cells and transitional epithelium, on the surface of the polyps, the absence of lesions at previous cystoscopies, the coexistence of cystitis cystica glandularis (a metaplastic lesion), and the older age group of our patients suggest that the prostatic-type epithelium in the polyps of urethra and urinary bladder is an acquired lesion, most likely a metaplastic response of transitional epithelium, which embryologically was multipotential.

Topics: Acid Phosphatase; Antigens, Neoplasm; Cystitis; Epithelium; Humans; Immunoenzyme Techniques; Male; Metaplasia; Middle Aged; Polyps; Prostate; Prostate-Specific Antigen; Urethra; Urethral Neoplasms; Urinary Bladder; Urinary Bladder Neoplasms

Topics: Acid Phosphatase; Animals; Cell Nucleus; Cystitis; Cytoplasm; Endoplasmic Reticulum; Epithelial Cells; Female; Golgi Apparatus; Guinea Pigs; Histocytochemistry; Inclusion Bodies; Lipids; Listeria monocytogenes; Listeriosis; Lysosomes; Microscopy; Microscopy, Electron; Urinary Bladder

Topics: Acid Phosphatase; Clinical Enzyme Tests; Cystitis; Glomerulonephritis; Humans; Kidney Diseases; Pyelonephritis; Uremia