Incidence of Sub-Clinical Prostatic Disease at Autopsy in the University College Hospital, Ibadan


This prospective study was undertaken to ascertain the incidence, histology and pathological features of different types of asymptomatic or sub clinical prostatic diseases. Prostate glands were obtained from 79 consecutive adult males aged 30 years and above who died from non-prostate related diseases at the University College Hospital Ibadan over an eighteen months period. The glands were weighed and fixed in 10% neutral buffered formalin. The sampling method of the prostate gland described by Vainer et al. (2011) was employed in this study. Paraffin-embedded sections were stained with haematoxylin and eosin and were systematically examined for focal prostate disease. The patients’ ages ranged from 30 to 86 years. The most common lesions were nodular hyperplasia (81%), followed by adenocarcinoma (6.3%). Three cases (3.8%) had schistosomiasis. Adenocarcinoma and nodular hyperplasia occurred in relatively older patients than those with normal glands or chronic prostatitis/schistosomiasis (p = 0.05). There was an increase in weight of the prostate with age (p < 0.001) and normal prostate glands weighed significantly less than diseased glands (p = 0.02). Focal prostatic atrophy was observed in 24.1% and metaplastic changes were observed in eight (10.1%) of the cases. Prostatic intraepithelial neoplasia (PIN) was not seen in any case, not even amongst the adenocarcinomas. The low frequency of prostatic adenocarcinoma and the absence of high grade prostatic intraepithelial neoplasia in this study despite the observation of increasing number of prostatic carcinoma required further investigation. Schistosomiasis was also found to be present in the adult male population.

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C. Okani, E. Akang and O. Ogunbiyi, "Incidence of Sub-Clinical Prostatic Disease at Autopsy in the University College Hospital, Ibadan," Open Journal of Urology, Vol. 3 No. 2, 2013, pp. 80-86. doi: 10.4236/oju.2013.32016.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. I. Epstein, “Adenocarcinoma of the Prostate,” In: Sternberg’s Diagnostic Surgical Pathology, 5th Edition, Lippincott Williams & Wilkins, New York, 2004, Chapter 45.
[2] M. A. Jackson, J. Kovi, M. Y. Heshmat, T. A. Ogunmuyiwa, G. W. Jones, A. O. Williams, et al., “Characterization of Prostatic Carcinoma among Blacks: A Comparison between a Low-Incidence Area, Ibadan, Nigeria, and a High-Incidence Area, Washington, DC,” Cancer Chemother Rep Prostate, 1980, pp. 185-205.
[3] M. A. Jackson, B. S. Ahluwalia, J. Herson, M. Y. Heshmat, A. G. Jackson, G. W. Jones, et al., “Characterization of Prostatic Carcinoma among Blacks: A Continuation Report,” Cancer Treat Rep, Vol. 61, No. 2, 1977, pp. 167-172.
[4] J. O. Ogunbiyi, “Cancer Incidence and Top Ten Cancers In Eleven Local Government Areas In Ibadan, Nigeria And Its Environs, 2004-2008,” Ibadan Cancer Registry, 2010.
[5] J. Kovi, “Cancer of the Prostate and Aging: An Autopsy Study in Black Men from Washington, DC, and Selected African Cities,” Prostate, Vol. 3, No. 1, 1982, pp. 73-80. doi:10.1002/pros.2990030110
[6] P. Humphrey, “The Prostate Gland, Silverberg’s Principals and Practice of Surgical Pathology and Cytopathology,” Lippincott Williams & Wilkins, New York, 2009, pp. 1791-1822.
[7] D. Dawam, A. H. Rafindadi and G. D. Kalayi, “Benign Prostatic Hyperplasia and Prostate Carcinoma in Native Africans,” BJU International, Vol. 85, No. 9, 2000, pp. 1074-1077. doi:10.1046/j.1464-410x.2000.00677.x
[8] A. Billis, “Prostatic Atrophy: Clinicopathological Significance,” BJU International, Vol. 36, No. 4, 2010, pp. 401-409. doi:10.1590/S1677-55382010000400003
[9] A. Billis, “Prostatic Atrophy: An Autopsy Study of a Histologic Mimic of Adenocarcinoma,” Modern Pathology, Vol. 11, No. 1, 1998, pp. 47-54.
[10] C. E. Ejike and L. U. Ezeanyika, “Prevalence of Chronic Prostatitis Symptoms in a Randomly Surveyed Adult Population of Urban-Community-Dwelling Nigerian Males,” International Journal of Urology, Vol. 15, No. 4, 2008, pp. 340-343. doi:10.1111/j.1442-2042.2008.02003.x
[11] J. Mehlhorn, “Prostatitis from the Morphologic Viewpoint—An Autopsy Analysis,” Zeitschrift Urologie Nephrologie, Vol. 80, No. 5, 1987, pp. 253-258.
[12] E. B. Attah, “Nonspecific Inflammatory Lesions of the Prostate. Spectrum and Patterns,” International Surgery, Vol. 60, No. 3, 1975, pp. 158-162.
[13] K. Stamatiou, A. Alvizos, E. Agapitos and F. Sofras, “Incidence of Impalpable Carcinoma of the Prostate and of Non-Malignant and Precarcinomatous Lesions in Greek Male Population: An Autopsy Study,” Prostate, Vol. 66, No. 12, 2006, pp. 1319-1328. doi:10.1002/pros.20339
[14] W. A. Sakr, A. Billis, P. Ekanem, T. Wilt and D. G. Bostwick, “Epidemiology of High-Grade Prostatic Intraepithelial Neoplasia,” Scandinavian Journal of Urology and Nephrology, Vol. 205, 2000, pp. 11-18. doi:10.1080/003655900750169275
[15] F. F. Angwafo III, A. Zaher, R. Befidi-Mengue, A. Wonkam, I. Takougang, I. Powell, et al., “The National Health Survey Team of The National Epidemiology Board of Cameroon: High-grade Intra-Epithelial Neoplasia and Prostate Cancer in Dibombari, Cameroon,” Prostate Cancer and Prostatic Diseases, Vol. 6, No. 1, 2003, pp. 34-38.
[16] M. A. Salami, B. Etukakpan and E. O. Olapade-Olaopa, “Update on Prostate Cancer in Black Men,” Journal of Men’s Health, Vol. 4, No. 4, 2007, pp. 456-463.
[17] B. Vainer, B. G. Toft, K. E. Olsen, G. K. Jacobseen and N. Marcussen, “Handling of Radical Prostatectomy Specimens: Total or Partial Embedding?” Histopathology, Vol. 58, No. 2, 2011, pp. 211-216. doi:10.1111/j.1365-2559.2011.03741.x
[18] A. R. Rich, “On the Frequency of Occurrence of Occult Carcinoma of the Prostate,” International Journal of Epidemiology, Vol. 36, No. 2, 2007, pp. 274-277. doi:10.1093/ije/dym050
[19] F. F. Angwafo III, A. Zaher, R. Befidi-Mengue, A. Wonkam, I. Takougang, I. Powell, et al., “The National Health Survey Team of The National Epidemiology Board of Cameroon: High-Grade Intra-Epithelial Neoplasia and Prostate Cancer in Dibombari, Cameroon,” Prostate Cancer and Prostatic Diseases, Vol. 6, No. 1, 2003, pp. 34-38.
[20] J. Adolfsson, “Commentary: On the Incidence of Histological Prostate Cancer and the Probable Diagnosis of Cases with Tumours Too Small to Produce Symptoms or to Attract Attention on Physical Examination—The Findings of Dr Arnold Rice Rich,” International Journal of Epidemiology, Vol. 36, No. 2, 2007, pp. 285-257. doi:10.1093/ije/dym053
[21] G. Soos, I. Tsakiris, J. Szanto, C. Turzo, P. G. Haas and B. Dezso, “The Prevalence of Prostate Carcinoma and Its Precursor in Hungary: An Autopsy Study,” European Urology, Vol. 48 No. 5, 2005, pp. 739-744. doi:10.1016/j.eururo.2005.08.010
[22] M. Gelfand, C. M. Ross, D. M. Blair, W. M. Castle and M. C. Weber, “Schistosomiasis of the Male Pelvic Organs. Severity of Infection as Determined by Digestion of Tissue and Histologic Methods in 300 Cadavers,” American Journal of Tropical Medicine and Hygiene, Vol. 19, No. 5, 1970, pp. 779-784.
[23] S. J. Berry, D. S. Coffey, P. C. Walsh, et al., “The Development of Human Prostatic Hyperplasia with Age,” Journal of Urology, Vol. 132, No. 3, 1984, pp. 474-479.
[24] R. Alexis and J. Domingo, “Schistosomiasis and Adenocarcinoma of Prostate. A Morphologic Study,” Human Pathology, Vol. 17 No. 7, 1986, pp. 757-760. doi:10.1016/S0046-8177(86)80188-5
[25] L. M. Franks, “Latent Carcinoma of the Prostate,” The Journal of Pathology and Bacteriology, Vol. 68, No. 2, 1954, pp. 603-616. doi:10.1002/path.1700680233
[26] W. A. Sakr, G. P. Haas and B. F. Cassin, “The Frequency of Carcinoma and Intraepithelial Neoplasia of the Prostate in Young Male Patients,” Journal of Urology, Vol. 150, No. 2, 1993, pp. 379-385.
[27] W. A. Sakr, D. J. Grignon, G. P. Haas, K. L. Schomer, L. K. Heibrun, B. J. Cassin, et al., “Epidemiology of High Grade Prostatic Intraepithelial Neoplasia,” Pathology— Research and Practice, Vol. 191, No. 9, 1995, pp. 838-841. doi:10.1016/S0344-0338(11)80965-9
[28] F. T. Odedina, T. O. Akinremi, F. Chinegwundoh, R. Roberts, D. Yu, R. R. Reams, et al., “Prostate Cancer Disparities in Black Men of African Descent: A Comparative Literature Review of Prostate Cancer Burden among Black Men in the United States, Caribbean, United Kingdom, and West Africa,” Infectious Agents and Cancer, Vol. 4, Suppl. 1, 2009, p. S2. doi:10.1186/1750-9378-4-S1-S2
[29] J. O. Ogunbiyi and O. B. Shittu, “Increased incidence of prostate cancer in Nigerians,” Journal of the National Medical Association, Vol. 91 No. 3, 1999, pp. 159-164.
[30] T. A. Badmus, A. R. Adesunkanmi, B. M. Yusuf, G. O. Oseni, A. K. Eziyi, T. I. Bakare, et al., “Burden of Prostate Cancer in South-Western Nigeria,” Urology, Vol. 76 No. 2, 2010, pp. 412-416. doi:10.1016/j.urology.2010.03.020
[31] G. A. Magoha, “Epidemiological and Clinical Aspects of Incidental Carcinoma of the Prostate in Africans: Experience at the Lagos University Teaching Hospital, Lagos and the Kenyatta National Hospital, Nairobi,” East African Medical Journal, Vol. 72, No. 5, 1995, pp. 283-287.
[32] A. Z. Mohammed, S. U. Alhassan, S. T. Edino and O. Ochicha, “Histopathological Review of Prostatic Diseases in Kano, Nigeria,” Nigerian Postgraduate Medical Journal, Vol. 10, No. 1, 2003, pp. 1-5.
[33] P. S. Gill, I. S. D. Roberts, L. Browning, R. Periera, A. Y. Warren, F. C. Hamdy and C. Verrill, “The Handling and Sampling of Radical Prostatectomy Specimens for Reporting and Research: The Oxford Approach,” Journal of Clinical Pathology, Vol. 65, No. 12, 2012, pp. 1057-1061. doi:10.1136/jclinpath-2012-200923
[34] D. G. Bostwick and I. Meiers, “Prostate,” In: N. Weidner, R. J. Cote, S. Suster and L. M. Weiss, Eds., Modern Surgical Pathology, Saunders Elsevier, Philadelphia, 2009, pp. 1121-1158. doi:10.1016/B978 -1-4160-3966-2.00032-1
[35] O. O. Erinomo, “Histopathological Pattern of Prostatic Lesions in Lagos University Teaching Hospital (LUTH) Lagos: A 12-Month Prospective Autopsy Study (January to December 2009),” Dissertation, The National Postgraduate Medical College of Nigeria, Lagos, 2010.
[36] G. M. Edington, I. Nwabuebo and T. A. Junaid, “The Pathology of Schistosomiasis in Ibadan, Nigeria with Special Reference to the Appendix, Brain, Pancreas and Genital Organs,” Transactions of the Royal Society of Tropical Medicine & Hygiene, Vol. 69, No. 1, 1975, pp. 153-156. doi:10.1016/0035-9203(75)90027-9
[37] C. C. Anunobi, A. A. Banjo, F. B. Abdulkareem, A. O. Daramola, O. R. Akinde and S. O. Elesha, “Bladder Cancer in Lagos: A 15 Year Histopathologic Review,” The Nigerian Postgraduate Medical Journal, Vol. 17, No. 1, 2010, pp. 40-44.
[38] R. J. Cohen, S. G. Edger and K. Cooker, “Schistosomiasis and Prostate Cancer,” Pathology, Vol. 27, No. 2, 1995, pp. 115-116. doi:10.1080/00313029500169682
[39] C. J. Godec, I. Grunberger and G. A. Carr, “Simultaneous Presence of Schistosomiasis and Advanced Cancer in Prostate,” Urology, Vol. 39, No. 6, 1992, pp. 547-549. doi:10.1016/0090-4295(92)90014-N
[40] T. K. F. Ma and J. R. Srigley, “Adenocarcinoma of Prostate and Schistosomiasis: A Rare Association,” Histopathology, Vol. 27, No. 2, 1995, pp. 187-189. doi:10.1111/j.1365-2559.1995.tb00028.x
[41] A. A. Cabasilio-de-Oliveira, E. F. Simon, W. A. EyerSilva, “Concomitant Prostatic Schistosomiasis and Adenocarcinoma: Case Report and Review,” Brazilian Journal of Infectious Diseases, Vol. 6, No. 1, 2002, pp. 45-49.
[42] F. M. E. Wagenlehner, J. E. Elkahwaji, F. Algaba, T. Bierklund-Johansen, K. G. Naber, R. Hartung, et al., “The Role of Inflammation and Infection in the Pathogenesis of Prostate Carcinoma,” BJU International, Vol. 100, No. 4, 2007, pp. 733-737. doi:10.1111/j.1464-410X.2007.07091.x
[43] G. S. Palpattu, S. Sutcliffe, P. J. Bastian, E. A. Platz, A. M. De Marzo, W. B. Isaacs, et al., “Prostate Carcinogenesis and Inflammation: Emerging Insights,” Carcinogenesis, Vol. 26, No. 7, 2004, pp. 1170-1181. doi:10.1093/carcin/bgh317
[44] A. Holsken, M. Gebhardt, M. Buchfelder, R. Fahlbush, I. Blumcke and R. Buselei, “EGFR Signaling Regulates Tumor Cell Migration in Craniopharyngiomas,” Clinical Cancer Research, Vol. 17, 2011, pp. 4367-4377. doi:10.1158/1078-0432.CCR-10-2811
[45] J. Edwards, P. Traynor, A. F. Munro, C. F. Pirret, B. Dunne and J. M. S. Bartlett, “The Role of HER1-HER4 and EGFRvIII in Hormone Refractory Prostate Cancer,” Clinical Cancer Research, Vol. 12, 2006, pp. 123-130. doi:10.1158/1078-0432.CCR-05-1445
[46] R. A. Moore, “The Evolution and Involution of the Prostate Gland,” American Journal of Pathology, Vol. 12, 1936, pp. 599-624.

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