Prostate Pathology

A 68-year-old man from Mumbai presents with progressive lower urinary tract symptoms for 6 months: nocturia (×4 per night), weak urinary stream, and incomplete emptying. Digital rectal examination reveals a smooth, firm, enlarged prostate without nodules. PSA is 2.8 ng/mL. Transrectal ultrasound shows diffuse glandular enlargement. Urinalysis is normal. What is the most likely pathological diagnosis?

A 72-year-old man from Delhi undergoes prostate biopsy for elevated PSA (18 ng/mL) and hard nodule on DRE. Histopathology shows glandular structures with cribriform pattern, nuclear enlargement, and prominent nucleoli. Gleason score is assigned as 4 + 4 = 8. Which of the following best describes the pathological significance of this Gleason score?

A 62-year-old man presents with lower urinary tract symptoms and a PSA level of 8.5 ng/mL. Digital rectal examination reveals a hard, irregular prostate. Which investigation is most appropriate to confirm the diagnosis of prostate cancer?

A 58-year-old man undergoes TRUS-guided prostate biopsy for elevated PSA and abnormal DRE. Histopathology shows adenocarcinoma with a Gleason score of 7 (3+4). Which investigation is most appropriate for assessing local staging and determining candidacy for nerve-sparing radical prostatectomy?

Regarding benign prostatic hyperplasia (BPH), all of the following statements are correct EXCEPT: