Premalignant Lesions of Prostate and Its Association with Nodular Hyperplasia and Carcinoma of Prostate: A Histomorphological Study
Keywords:
histomorphology, premalignant, prostatic lesions.
Abstract
Background: Identification of premalignant proliferative changes has gained importance for early diagnosis of prostatic carcinoma. In clinical practice knowing the frequency of a prostatic carcinoma diagnosed on repeat biopsies would aid primary treating physicians regarding their decisions in suspicious cases.Aims and Objectives: 1. To identify the histomorphological features of premalignant lesions of prostate. & 2. To know the association of premalignant lesion with benign and malignant lesions of prostate.Methods: This descriptive study was performed in the department of pathology during the study period of six years (2009-2015). A total of 1,023 prostatic biopsies were studied for the presence and association of premalignant conditions of prostate. Statistical analysis was done using SPSS 17.0.Results: A total of 385 (37.63 %) were diagnosed as premalignant lesions of prostate. High grade prostatic intraepithelial neoplasia (HGPIN) constituted 71.6% of the cases followed by proliferative inflammatory atrophy (PIA) and atypical adenomatous hyperplasia (AAH) in 15.06% and 13.2% of the cases respectively.Conclusion: HGPIN and PIA showed strong association with carcinoma and AAH showed weaker association with carcinoma of prostate. Hence the histomorphological diagnosis of HGPIN, PIA should be highlighted in the biopsies by the pathologist and advised for repeat biopsy of the entire gland, irrespective of clinical, biochemical and radiological findings.References
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18. Henry B.A and Anil. V.P. Atypical adenomatous hyperplasia (adenosis) of the prostate: a case report with review of the literature. Diagnostic pathology 2008;3:34.
19. Mettlin C, Jones GW, Murphy GP. Trends in prostate cancer in the United States, 1974-1990: Observations from the patient care evaluation studies of the American college of surgeons commission on cancer. CA Cancer J Clin 1993;43:83-91.
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22. van Leenders GJ, Gage WR, Hicks JL, van Balken B, Aalders TW, Schalken JA, et al. Intermediate cells in human prostate epithelium are enriched in proliferative inflammatory atrophy. Am J Pathol 2003;162:1529-37.
23. Putzi MJ, De Marzo AM: Morphologic transitions between proliferative inflammatory atrophy and high-grade prostatic intraepithelial neoplasia. Urology 2000;56: 828-32.
24. Wang W, Bergh A, Damber JE: Morphological transition of proliferative inflammatory atrophy to high-grade intraepithelial neoplasia and cancer in human prostate.Prostate 2009;69:1378-86.
25. De Marzo AM, Meeker AK, Zha S, Luo J, Nakayama M, Platz EA, et al.: Human prostate cancer precursors and pathobiology. Urology.2003; 62:55-62.
26. Postma R, Schroder FH, van der Kwast Th: Atrophy in prostate needle biopsy cores and its relationship to prostate cancer incidence in screened men. Urology 2005; 65:745-9
of Turkish males. Turkish Journal of Urology 2009;35:96-100.
2. Del Regato JA, Sput HJ, Cox JD. Pathology of cancer. In: Harsh Berger SE, Kasper R, editors. Cancer diagnosis, treatment and prognosis. St Louis: Mosby 1985. p. 27-8.
3. Rekhi B, Jaswal TS, Arora B. Premalignant Lesions of Prostate and their Association with Nodular Hyperplasia and Carcinoma Prostate. Indian Journal of Cancer 2000 ; 41:60 – 5.
4. Athanase Billis. Prostatic Atrophy. Clinicopathological Significance. Int Braz J Urol 2010; 36: 401- 9.
5. Sakr AW, Montironi R, Epstein IJ, Rubin AM, Demarzo MA, Humphrey AP, et al. Prostatic intraepithelial neoplasia. In: Eble NJ, Sauter G, Epstein IJ, Sesterhenn AI editors. Pathologyand genetics tumors of the urinary system and male genital organs Lyon: IARC Press (World Health Organization. Classification of tumors 2004; 6: p.193-8.
6. Howel WM and Black DA.Controlled silver staining of nucleolus organizer regions with a protective colloidal developer: a 1- step method. Experientia 1980;15; 36:1014-5
7. Kovarik S, Davidsohn I, Stejskal: ABO antigens in cancer. Detection with Mixed cell agglutination reaction. Arch Pathol 1968; 86:12-21.
8. Bostwick GD, Sakr W. Prostatic intraepithelial neoplasia. In: Foster SC, Bostwick GD editors. Pathology of the prostate. Philadelphia: W.B. Saunders (Major problems in pathology) 1998 ;( 34):p.95-114.
9. Gaudin BP, Epstein IJ. Adenosis of the prostate: Histologic features in needle biopsy specimens. Am J Surg Pathol 1995; 9:737-47.
10. Rosai J. Male reproductive system. In: Rosai & Ackerman’s. Surgical Pathology. 9t h ed. Vol.1, Missouri: Mosby. 2004. p.1361-1412.
11. Rodolfo M, Roberta M, Ferran A, Antonio L. Morphological identification of the patterns of prostatic intraepithelial neoplasia and their importance. J Clin Pathol 2000; 53: 655-65.
12. Davidson D, Bostwick DG, Qian J, Sioky M, Rudders R, Stilamant M. Prostatic intraepithelial neoplasia is predictive of adenocarcinoma. J Urol 1995;154:1295-9.
13. Paulo E. F, M. Tobias-Machado, Marcelo A. P, Lucilla H.S, Eric R. W. Twelve Core Prostate Biopsy Versus Six Systematic Sextant Biopsies. Braz J Urol 2002;28:207-13.
14. Haggman JM, Macoska AJ, Wojno JK, Oesterling EJ. The relationship between prostatic intraepithelial neoplasia and prostate cancer: Critical issues. J Urol 1997; 158:12-22.
15. Mc Neal JE. Morphogenesis of prostatic carcinoma. Cancer 1985;1659-66.
16. Rosai J. Male reproductive system. In: Rosai J, editor. Ackerman’s Surgical pathology. 8th Ed. Missouri: Mosby-year book Inc 1996. p. 21-56.
17. Bostick DG, Qian J: Atypical adenomatous hyperplasia of the prostate. Relationship with carcinoma in 217 whole-mount radical prostatecctomies. Am J Surg Pathol 1995;19: 506-18.
18. Henry B.A and Anil. V.P. Atypical adenomatous hyperplasia (adenosis) of the prostate: a case report with review of the literature. Diagnostic pathology 2008;3:34.
19. Mettlin C, Jones GW, Murphy GP. Trends in prostate cancer in the United States, 1974-1990: Observations from the patient care evaluation studies of the American college of surgeons commission on cancer. CA Cancer J Clin 1993;43:83-91.
20. Orhan Koca, Selahattin Çalışkan, Metin İshak Öztürk, Mustafa Güneş, M. Ihsan Karaman. Significance of Atypical Small Acinar Proliferation and High-Grade Prostatic Intraepithelial Neoplasia in Prostate Biopsy. Korean J Urol 2011;52:736-40
21. De Marzo AM, Marchi VL, Epstein JI, Nelson WG: Proliferative inflammatory atrophy of the prostate: implications for prostatic carcinogenesis. Am J Pathol 1999;155:1985- 92.
22. van Leenders GJ, Gage WR, Hicks JL, van Balken B, Aalders TW, Schalken JA, et al. Intermediate cells in human prostate epithelium are enriched in proliferative inflammatory atrophy. Am J Pathol 2003;162:1529-37.
23. Putzi MJ, De Marzo AM: Morphologic transitions between proliferative inflammatory atrophy and high-grade prostatic intraepithelial neoplasia. Urology 2000;56: 828-32.
24. Wang W, Bergh A, Damber JE: Morphological transition of proliferative inflammatory atrophy to high-grade intraepithelial neoplasia and cancer in human prostate.Prostate 2009;69:1378-86.
25. De Marzo AM, Meeker AK, Zha S, Luo J, Nakayama M, Platz EA, et al.: Human prostate cancer precursors and pathobiology. Urology.2003; 62:55-62.
26. Postma R, Schroder FH, van der Kwast Th: Atrophy in prostate needle biopsy cores and its relationship to prostate cancer incidence in screened men. Urology 2005; 65:745-9
Published
2016-02-23
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