Atrophy of the prostate gland: Difference between revisions
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| Caption = Atrophic prostatic glands. [[H&E stain]]. | | Caption = Atrophic prostatic glands. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = glands typically have a jagged edges/prows (in cancer the glands tend to have round edges), gland density is usually lower than in prostate carcinoma (glands are not back-to-back), nuclei small & hyperchromatic, scant cytoplasm | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[prostate carcinoma]] - esp. [[atrophic prostate carcinoma]], [[atypical small acinar proliferation]] | | LMDDx = [[prostate carcinoma]] - esp. [[atrophic prostate carcinoma]], [[atypical small acinar proliferation]] | ||
| Stains = | | Stains = | ||
| IHC = AMACR -ve, p63 +ve (basal cells), CK34betaE12 +ve (basal cells) | | IHC = [[AMACR]] -ve, [[p63]] +ve (basal cells), [[CK34betaE12]] +ve (basal cells) | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
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}} | }} | ||
'''Atrophy of the prostate gland''', also '''prostatic atrophy''', is a common change in the [[prostate gland]]. | '''Atrophy of the prostate gland''', also '''prostatic atrophy''', is a common change in the [[prostate gland]]. | ||
==General== | ==General== | ||
*Considered to be the most common mimicker of [[prostate carcinoma]].<ref name=pmid18408595>{{Cite journal | last1 = Wang | first1 = W. | last2 = Sun | first2 = X. | last3 = Epstein | first3 = JI. | title = Partial atrophy on prostate needle biopsy cores: a morphologic and immunohistochemical study. | journal = Am J Surg Pathol | volume = 32 | issue = 6 | pages = 851-7 | month = Jun | year = 2008 | doi = 10.1097/PAS.0b013e31815a0508 | PMID = 18408595 }}</ref> | *Considered to be the most common mimicker of [[prostate carcinoma]].<ref name=pmid18408595>{{Cite journal | last1 = Wang | first1 = W. | last2 = Sun | first2 = X. | last3 = Epstein | first3 = JI. | title = Partial atrophy on prostate needle biopsy cores: a morphologic and immunohistochemical study. | journal = Am J Surg Pathol | volume = 32 | issue = 6 | pages = 851-7 | month = Jun | year = 2008 | doi = 10.1097/PAS.0b013e31815a0508 | PMID = 18408595 }}</ref> | ||
*Small glands | *Small glands - may mimic [[Gleason score|Gleason pattern]] 3. | ||
*Inflammatory atrophy seems to be related to [[HGPIN]] and [[prostate cancer]];<ref name=pmid10595928>{{Cite journal | last1 = De Marzo | first1 = AM. | last2 = Marchi | first2 = VL. | last3 = Epstein | first3 = JI. | last4 = Nelson | first4 = WG. | title = Proliferative inflammatory atrophy of the prostate: implications for prostatic carcinogenesis. | journal = Am J Pathol | volume = 155 | issue = 6 | pages = 1985-92 | month = Dec | year = 1999 | doi = 10.1016/S0002-9440(10)65517-4 | PMID = 10595928 }}</ref> however, the epidemiology is not compelling that this is a significant (clinical) association.<ref name=pmid24129226>{{Cite journal | last1 = Celma | first1 = A. | last2 = Servián | first2 = P. | last3 = Planas | first3 = J. | last4 = Placer | first4 = J. | last5 = Quilez | first5 = MT. | last6 = Arbós | first6 = MA. | last7 = de Torres | first7 = I. | last8 = Morote | first8 = J. | title = Clinical Significance of Proliferative Inflammatory Atrophy in Prostate Biopsy. | journal = Actas Urol Esp | volume = 38 | issue = 2 | pages = 122-126 | month = Mar | year = 2014 | doi = 10.1016/j.acuro.2013.04.008 | PMID = 24129226 }}</ref> | *Inflammatory atrophy seems to be related to [[HGPIN]] and [[prostate cancer]];<ref name=pmid10595928>{{Cite journal | last1 = De Marzo | first1 = AM. | last2 = Marchi | first2 = VL. | last3 = Epstein | first3 = JI. | last4 = Nelson | first4 = WG. | title = Proliferative inflammatory atrophy of the prostate: implications for prostatic carcinogenesis. | journal = Am J Pathol | volume = 155 | issue = 6 | pages = 1985-92 | month = Dec | year = 1999 | doi = 10.1016/S0002-9440(10)65517-4 | PMID = 10595928 }}</ref> however, the epidemiology is not compelling that this is a significant (clinical) association.<ref name=pmid24129226>{{Cite journal | last1 = Celma | first1 = A. | last2 = Servián | first2 = P. | last3 = Planas | first3 = J. | last4 = Placer | first4 = J. | last5 = Quilez | first5 = MT. | last6 = Arbós | first6 = MA. | last7 = de Torres | first7 = I. | last8 = Morote | first8 = J. | title = Clinical Significance of Proliferative Inflammatory Atrophy in Prostate Biopsy. | journal = Actas Urol Esp | volume = 38 | issue = 2 | pages = 122-126 | month = Mar | year = 2014 | doi = 10.1016/j.acuro.2013.04.008 | PMID = 24129226 }}</ref> | ||
===Classification=== | |||
It can be classified into:<ref name=pmid20815946>{{Cite journal | last1 = Billis | first1 = A. | title = Prostatic atrophy. Clinicopathological significance. | journal = Int Braz J Urol | volume = 36 | issue = 4 | pages = 401-9 | month = | year = | doi = | PMID = 20815946 }}</ref> | |||
#Focal prostatic atrophy. | |||
#Diffuse prostatic atrophy. | |||
Focal atrophy can be subclassified as:<ref name=pmid20815946/> | |||
#Partial. | |||
#Complete. | |||
#Combined. | |||
==Microscopic== | ==Microscopic== | ||
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===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: Atrophic prostatic glands -- low mag.jpg | APG - low mag. (WC) | |||
Image: Atrophic prostatic glands -- intermed mag.jpg | APG - intermed. mag. | Image: Atrophic prostatic glands -- intermed mag.jpg | APG - intermed. mag. (WC) | ||
Image: Atrophic prostatic glands -- high mag.jpg | APG - high mag. (WC) | |||
Image: Atrophic prostatic glands -- very high mag.jpg | APG - very high mag. | Image: Atrophic prostatic glands -- very high mag.jpg | APG - very high mag. (WC) | ||
</gallery> | </gallery> | ||
www: | |||
*[http://webpathology.com/image.asp?case=16&n=7 Atrophy (webpathology.com)]. | |||
*[http://webpathology.com/image.asp?case=16&n=5 Partial atrophy (webpathology.com)]. | |||
*[http://webpathology.com/image.asp?case=16&n=6 Sclerotic atrophy (webpathology.com)]. | |||
==IHC== | |||
*Classically like normal prostate (AMACR -ve, p63 +ve, CK34betaE12 +ve). | |||
**May be negative for basal cell markers, i.e. p63 and CK34betaE12.<ref name=pmid18408595>{{cite journal |author=Wang W, Sun X, Epstein JI |title=Partial atrophy on prostate needle biopsy cores: a morphologic and immunohistochemical study |journal=Am. J. Surg. Pathol. |volume=32 |issue=6 |pages=851–7 |year=2008 |month=June |pmid=18408595 |doi=10.1097/PAS.0b013e31815a0508 |url=}}</ref> | |||
==Sign out== | ==Sign out== | ||
Generally, this finding is ''not'' reported; it is considered a normal finding. | Generally, this finding is ''not'' reported; it is considered a normal finding. | ||
<pre> | |||
Left Apex: | |||
- Benign prostate tissue with glandular atrophy. | |||
</pre> | |||
===Micro=== | |||
The core shows rare, spaced, atrophic appearing glands, mostly with a wavy border and a decreased quantity of cytoplasm. Prominent nucleoli and significant nuclear enlargement are not identified. | |||
There are none of the following: mitoses, adjacent PIN, suspicious luminal material, nuclear hyperchromasia. | |||
==See also== | ==See also== | ||