Pseudohyperplastic prostate carcinoma: histologic patterns and differential diagnosis
| Autor: | Claudia Natalia Aleman-Sanchez, Julián Arista-Nasr, Elizmara Aguilar-Ayala, Jorge Albores-Saavedra, Leticia Bornstein-Quevedo, Braulio Martínez-Benítez |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Prostatic Intraepithelial Neoplasia Pathology medicine.medical_specialty business.industry Prostatic Hyperplasia Prostatic Neoplasms General Medicine medicine.disease Malignancy Immunohistochemistry Pathology and Forensic Medicine Diagnosis Differential medicine.anatomical_structure Prostate medicine Carcinoma Adenocarcinoma Neoplasm Humans Prostate neoplasm Nuclear atypia Differential diagnosis business |
| Zdroj: | Annals of diagnostic pathology. 19(4) |
| ISSN: | 1532-8198 |
| Popis: | The similarity between some carcinomas and many benign glandular proliferations has been mentioned in the literature for decades. The description of the main histologic features of pseudohyperplastic carcinoma has been very useful in avoiding errors of interpretation, particularly false-negative results. In recent years, we have found some histologic variants of this neoplasm that have not been mentioned previously. In order to classify the different histologic growth patterns and comment on their differential diagnosis, we reviewed the architectural and cytologic features of 34 cases of pseudohyperplastic adenocarcinoma in 2 radical prostatectomies, 4 transurethral resections, and 28 needle biopsies. Growth patterns most commonly observed included nodular, complex, and mixed (nodular and complex) patterns. Other less frequent histologic varieties included adenosis-like pattern, prostatic intraepithelial neoplasia–like pattern, pseudohyperplastic adenocarcinoma with xanthomatous features, and limited pseudohyperplastic adenocarcinoma. Frequent changes in neoplastic glands included papillary infoldings, large/cystic glands, and branching. Criteria associated with malignancy include nuclear enlargement (92%), apparent nucleoli (85%), pink amorphous secretions (78%), and transition to small acinar carcinoma (70%). However, in some biopsies, nuclear atypia was little apparent. Fifteen of the 34 cases were misdiagnosed as benign and 5 as other malignant neoplasms, and included the following diagnoses: hyperplastic nodules (11), prostatic adenosis (2), diffuse adenosis of the peripheral zone (1), benign cystic glands (1), and less frequently other malignant tumors including xanthomatous carcinoma (2), low-grade prostatic adenocarcinoma (2), and atrophic carcinoma (1). It is important to recognize the different growth patterns of this neoplasm in order to avoid an underdiagnosis of malignancy. |
| Databáze: | OpenAIRE |
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