Study of Latent Carcinoma of the Prostate in the Japanese Based on Necropsy Material

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Abstract
The author examined by serial section the prostates of 229 male autopsy cases over the age of 40 who did not have any signs or symptoms of prostatic carcinoma during their life time. Malignant foci were found in 25 of the 229 cases. Each focus was located inside the capsule and could be designated as latent carcinoma. The incidence of latent carcinoma in Japan is almost the same as in Europe and America while the death-rate for prostatic carcinoma is lower. The site of origin of latent carcinoma was the posterior lobe in 12 cases, the lateral lobe in 11 cases, and the anterior lobe in 2 cases. The incidence in the posterior and lateral lobes was almost the same. They originated near the capsule and from the median portion and only a few cases were found above the seminal colliculus. In 2 cases 2 foci were found distant from each other. Most cases were small acinar adenocarcinomas; in 2 cases incomplete cribriform arrangement and in 1 case an anaplastic type with little tendency to acinar formation were found. There were no squamous cell carcinomas. The nuclei of carcinoma cells showed nucleoli and paleness of the centers. The irregular relationship between malignant acini and their surrounding tissues was characteristic, and the invasion into the perineural lymphatics often found was a definite index of invasiveness, but the vascular and capsular invasion were rare. Carcinoma was often associated with nodular hypertrophy, but there was no causal relationship between them, and moreover no direct relationship with atrophy. However, hypertrophic glandular acini around the malignant lesion were at times recognizable and proliferative changes seemed to be more common than atrophy. In malignant foci, a mucicarmine-positive substance which is not present in normal tissue is often found. No conclusion could be drawn as to the relationship between latent carcinoma and clinically manifest carcinoma, the causes of latency, and the reasons for the lower death-rate for prostatic carcinoma in Japan.

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