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Difference between revisions of "Atypical small acinar proliferation"
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Atypical small acinar proliferation (view source)
Revision as of 03:28, 12 October 2022
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Atypical small acinar proliferation - alt -- intermed mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Atypical small acinar proliferation - top-left of image. [[H&E stain]]. | ||
| Synonyms = suspicious for prostate carcinoma | | Synonyms = suspicious for prostate carcinoma | ||
| Micro = morphology of prostate carcinoma but less than 6 glands (major criteria: abnormal architecture (increased gland density, usu. small circular glands, "infiltrative growth" pattern), basal cells lost, cytological abnormalities (nuclear enlargement, nucleoli); minor criteria: nuclear hyperchromasia, wispy blue mucin, pink amorphous secretions, intraluminal crystalloid, amphophilic cytoplasm, adjacent HGPIN, mitoses) | | Micro = morphology of prostate carcinoma but less than 6 glands (major criteria for prostate carcinoma: abnormal architecture (increased gland density, usu. small circular glands, "infiltrative growth" pattern), basal cells lost, cytological abnormalities (nuclear enlargement, nucleoli); minor criteria for prostate carcinoma: nuclear hyperchromasia, wispy blue mucin, pink amorphous secretions, intraluminal crystalloid, amphophilic cytoplasm, adjacent HGPIN, mitoses) | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[prostate adenocarcinoma]], benign prostate | | LMDDx = [[prostate adenocarcinoma]], benign prostate | ||
| Stains = | | Stains = | ||
| IHC = AMACR +ve, CK34betaE12 -ve, p63 -ve, PSA +ve | | IHC = AMACR +ve, [[CK34betaE12]] -ve, p63 -ve, PSA +ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
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**One benchmark is < 3-5% of biopsies.<ref name=THvdK>THvdK. 19 June 2010.</ref> | **One benchmark is < 3-5% of biopsies.<ref name=THvdK>THvdK. 19 June 2010.</ref> | ||
*Never diagnosed on excision, i.e. prostatectomy specimen. | *Never diagnosed on excision, i.e. prostatectomy specimen. | ||
*Cancers diagnosed in biopsies after ASAP are not more frequently clinically significant than cancers diagnosed after a diagnosis of benign or HGPIN.<ref name=pmid28888752>{{Cite journal | last1 = Wiener | first1 = S. | last2 = Haddock | first2 = P. | last3 = Cusano | first3 = J. | last4 = Staff | first4 = I. | last5 = McLaughlin | first5 = T. | last6 = Wagner | first6 = J. | title = Incidence of Clinically Significant Prostate Cancer After a Diagnosis of Atypical Small Acinar Proliferation, High-grade Prostatic Intraepithelial Neoplasia, or Benign Tissue. | journal = Urology | volume = 110 | issue = | pages = 161-165 | month = Dec | year = 2017 | doi = 10.1016/j.urology.2017.08.040 | PMID = 28888752 }}</ref> | |||
===Association with adenocarcinoma=== | ===Association with adenocarcinoma=== | ||
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==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Atypical appearing acini. | *Atypical appearing acini - see criteria for ''[[prostate adenocarcinoma]]''. | ||
*Limited extent - '''key feature'''. | *Limited extent - '''key feature'''. | ||
**Less than six glands.† | **Less than six glands.† | ||
| Line 62: | Line 63: | ||
**Adenosis of the prostate. | **Adenosis of the prostate. | ||
**Sclerosing adenosis of the prostate. | **Sclerosing adenosis of the prostate. | ||
===Images=== | |||
<gallery> | |||
Image: Atypical small acinar proliferation -- low mag.jpg | ASAP - low mag. | |||
Image: Atypical small acinar proliferation -- intermed mag.jpg | ASAP - intermed. mag. | |||
Image: Atypical small acinar proliferation - alt -- intermed mag.jpg | ASAP - intermed. mag. | |||
Image: Atypical small acinar proliferation -- high mag.jpg | ASAP - high mag. | |||
Image: Atypical small acinar proliferation -- very high mag.jpg | ASAP - very high mag. | |||
</gallery> | |||
==IHC== | ==IHC== | ||
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Note: | Note: | ||
* | *Often ''not'' contributory. | ||
===Images=== | |||
<gallery> | |||
Image: Atypical small acinar proliferation - AMACR-CK34betaE12 -- intermed mag.jpg | ASAP - intermed. mag. | |||
Image: Atypical small acinar proliferation - AMACR-CK34betaE12 -- high mag.jpg | ASAP - high mag. | |||
Image: Atypical small acinar proliferation - AMACR-CK34betaE12 -- very high mag.jpg | ASAP - very high mag. | |||
Image: Atypical small acinar proliferation - AMACR-CK34betaE12 - alt -- very high mag.jpg | ASAP - very high mag. | |||
</gallery> | |||
==Sign out== | ==Sign out== | ||
<pre> | |||
C. Prostate, Left Base: | |||
- Atypical prostatic glands, suspicious for microfocus of adenocarcinoma. | |||
</pre> | |||
===Block letters=== | |||
<pre> | <pre> | ||
K. PROSTATE, LEFT LATERAL INTERIOR, BIOPSY: | K. PROSTATE, LEFT LATERAL INTERIOR, BIOPSY: | ||
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*[[Waffle diagnosis]]. | *[[Waffle diagnosis]]. | ||
*[[Prostate gland]]. | *[[Prostate gland]]. | ||
*[[Atypical intraductal proliferation]]. | |||
==References== | ==References== | ||