Difference between revisions of "Prostatic stromal tumour of uncertain malignant potential"
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'''Prostatic stromal tumour of uncertain malignant potential''', | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Prostatic stromal tumor of uncertain malignant potential - 1 WBAL.jpg | |||
| Width = | |||
| Caption = Prostatic stromal tumour of uncertain malignant potential. (WC/George Netto) | |||
| Synonyms = prostatic stromal proliferation of uncertain malignant potential | |||
| Micro = increased stromal cellularity, +/-nuclear atypia, +/-benign glands, lack small round blood vessels, no necrosis, no or minimal mitotic activity | |||
| Subtypes = | |||
| LMDDx = [[prostatic stromal sarcoma]], stromal nodule in [[benign prostatic hyperplasia]], [[leiomyosarcoma]], [[rhabdomyosarcoma]], [[sarcomatoid prostate carcinoma]] | |||
| Stains = | |||
| IHC = CD34 +ve, ER +ve, PR +ve, vimentin +ve, panker -ve{{fact}} | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[prostate gland]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = 20s-80s - typically 50s and 60s | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = very rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = usually good | |||
| Other = | |||
| ClinDDx = other tumours of the prostate, benign prostate, [[BPH]] | |||
| Tx = | |||
}} | |||
'''Prostatic stromal tumour of uncertain malignant potential''', abbreviated '''PSTUMP''', is a rare lesion of the prostatic stroma which cannot be definitively classified as benign or malignant. | |||
It may be abbreviated as '''[[STUMP]]''';<ref name=pmid22388992/> an abbreviation used for a [[smooth muscle tumour of uncertain malignant potential|uterine lesion of uncertain malignant potential]]. | |||
It is also known as '''prostatic stromal proliferation of uncertain malignant potential''' (abbreviated '''PSPUMP''').<ref name=pmid9500215>{{Cite journal | last1 = Gaudin | first1 = PB. | last2 = Rosai | first2 = J. | last3 = Epstein | first3 = JI. | title = Sarcomas and related proliferative lesions of specialized prostatic stroma: a clinicopathologic study of 22 cases. | journal = Am J Surg Pathol | volume = 22 | issue = 2 | pages = 148-62 | month = Feb | year = 1998 | doi = | PMID = 9500215 }}</ref> | It is also known as '''prostatic stromal proliferation of uncertain malignant potential''' (abbreviated '''PSPUMP''').<ref name=pmid9500215>{{Cite journal | last1 = Gaudin | first1 = PB. | last2 = Rosai | first2 = J. | last3 = Epstein | first3 = JI. | title = Sarcomas and related proliferative lesions of specialized prostatic stroma: a clinicopathologic study of 22 cases. | journal = Am J Surg Pathol | volume = 22 | issue = 2 | pages = 148-62 | month = Feb | year = 1998 | doi = | PMID = 9500215 }}</ref> | ||
| Line 5: | Line 38: | ||
==General== | ==General== | ||
*Rare. | *Rare. | ||
*Typically a good prognosis; however, there are some reports of progression to [[prostatic stromal sarcoma]].<ref name=pmid17170745/> | |||
*Wide age range (20s-80s) - but usually 50s and 60s. | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Overgrowth of spindle cells - "hypercellular stroma" - '''key feature'''.<ref name=pmid22388992/> | |||
*+/-Atypical nuclei.<ref name=pmid22388992/> | |||
*+/-Multinucleation. | |||
*Lack prominent vessels - distinguishes from stromal nodule in BPH.<ref name=pmid17170745>{{Cite journal | last1 = Hansel | first1 = DE. | last2 = Herawi | first2 = M. | last3 = Montgomery | first3 = E. | last4 = Epstein | first4 = JI. | title = Spindle cell lesions of the adult prostate. | journal = Mod Pathol | volume = 20 | issue = 1 | pages = 148-58 | month = Jan | year = 2007 | doi = 10.1038/modpathol.3800676 | PMID = 17170745 }}</ref> | |||
Note: | Note: | ||
*Do not have [[necrosis]] and no or minimal mitotic activity - '''important'''.<ref name=pmid22388992/> | |||
*May be seen with glandular abnormalities.<ref name=pmid21572264>{{Cite journal | last1 = Nagar | first1 = M. | last2 = Epstein | first2 = JI. | title = Epithelial proliferations in prostatic stromal tumors of uncertain malignant potential (STUMP). | journal = Am J Surg Pathol | volume = 35 | issue = 6 | pages = 898-903 | month = Jun | year = 2011 | doi = 10.1097/PAS.0b013e318214f2f2 | PMID = 21572264 }}</ref> | *May be seen with glandular abnormalities.<ref name=pmid21572264>{{Cite journal | last1 = Nagar | first1 = M. | last2 = Epstein | first2 = JI. | title = Epithelial proliferations in prostatic stromal tumors of uncertain malignant potential (STUMP). | journal = Am J Surg Pathol | volume = 35 | issue = 6 | pages = 898-903 | month = Jun | year = 2011 | doi = 10.1097/PAS.0b013e318214f2f2 | PMID = 21572264 }}</ref> | ||
DDx: | DDx: | ||
*Prostatic stromal sarcoma.<ref name=pmid22388992>{{Cite journal | last1 = De Berardinis | first1 = E. | last2 = Busetto | first2 = GM. | last3 = Antonini | first3 = G. | last4 = Giovannone | first4 = R. | last5 = Di Placido | first5 = M. | last6 = Magliocca | first6 = FM. | last7 = Di Silverio | first7 = A. | last8 = Gentile | first8 = V. | title = Incidental prostatic stromal tumor of uncertain malignant potential (STUMP): histopathological and immunohistochemical findings. | journal = Urologia | volume = 79 | issue = 1 | pages = 65-8 | month = | year = 2012 | doi = 10.5301/RU.2012.9099 | PMID = 22388992 }}</ref> | *Stromal proliferation in [[benign prostatic hyperplasia]]. | ||
*[[Prostatic stromal sarcoma]].<ref name=pmid22388992>{{Cite journal | last1 = De Berardinis | first1 = E. | last2 = Busetto | first2 = GM. | last3 = Antonini | first3 = G. | last4 = Giovannone | first4 = R. | last5 = Di Placido | first5 = M. | last6 = Magliocca | first6 = FM. | last7 = Di Silverio | first7 = A. | last8 = Gentile | first8 = V. | title = Incidental prostatic stromal tumor of uncertain malignant potential (STUMP): histopathological and immunohistochemical findings. | journal = Urologia | volume = 79 | issue = 1 | pages = 65-8 | month = | year = 2012 | doi = 10.5301/RU.2012.9099 | PMID = 22388992 }}</ref> | |||
*[[Leiomyosarcoma]]. | *[[Leiomyosarcoma]]. | ||
*[[Rhabdomyosarcoma]]. | *[[Rhabdomyosarcoma]]. | ||
*[[Sarcomatoid prostate carcinoma]] - often associated with conventional prostate carcinoma & history of radiation. | |||
===Subclassification=== | |||
May be subclassified as per Gaudin ''et al.'':<ref name=pmid9500215>{{Cite journal | last1 = Gaudin | first1 = PB. | last2 = Rosai | first2 = J. | last3 = Epstein | first3 = JI. | title = Sarcomas and related proliferative lesions of specialized prostatic stroma: a clinicopathologic study of 22 cases. | journal = Am J Surg Pathol | volume = 22 | issue = 2 | pages = 148-62 | month = Feb | year = 1998 | doi = | PMID = 9500215 }}</ref> | |||
#Scattered atypical cells with benign glands. | |||
#Minimal atypical cells. | |||
#Leaf like growth pattern (phyllodes-like). | |||
#Atypical cells without glands. | |||
===Images=== | |||
<gallery> | |||
Image: Prostatic stromal tumor of uncertain malignant potential - 1 WBAL.jpg | STUMP - 1 (WC/Netto) | |||
Image: Prostatic stromal tumor of uncertain malignant potential - 2 WBAL.jpg | STUMP - 2 (WC/Netto) | |||
</gallery> | |||
====www==== | |||
*[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-138-11-1542-f01&doi=10.5858%2Farpa.2013-0212-RS STUMP (archivesofpathology.org)].<ref name=pmid25357117>{{Cite journal | last1 = Murer | first1 = LM. | last2 = Talmon | first2 = GA. | title = Stromal tumor of uncertain malignant potential of the prostate. | journal = Arch Pathol Lab Med | volume = 138 | issue = 11 | pages = 1542-5 | month = Nov | year = 2014 | doi = 10.5858/arpa.2013-0212-RS | PMID = 25357117 }}</ref> | |||
==IHC== | ==IHC== | ||
| Line 27: | Line 84: | ||
*[[Prostate gland]]. | *[[Prostate gland]]. | ||
*[[Waffle diagnosis]]. | *[[Waffle diagnosis]]. | ||
*[[Smooth muscle tumour of uncertain malignant potential]]. | |||
==References== | ==References== | ||
Latest revision as of 16:16, 3 January 2022
| Prostatic stromal tumour of uncertain malignant potential | |
|---|---|
| Diagnosis in short | |
 Prostatic stromal tumour of uncertain malignant potential. (WC/George Netto) | |
|
| |
| Synonyms | prostatic stromal proliferation of uncertain malignant potential |
|
| |
| LM | increased stromal cellularity, +/-nuclear atypia, +/-benign glands, lack small round blood vessels, no necrosis, no or minimal mitotic activity |
| LM DDx | prostatic stromal sarcoma, stromal nodule in benign prostatic hyperplasia, leiomyosarcoma, rhabdomyosarcoma, sarcomatoid prostate carcinoma |
| IHC | CD34 +ve, ER +ve, PR +ve, vimentin +ve, panker -ve[citation needed] |
| Site | prostate gland |
|
| |
| Clinical history | 20s-80s - typically 50s and 60s |
| Prevalence | very rare |
| Prognosis | usually good |
| Clin. DDx | other tumours of the prostate, benign prostate, BPH |
Prostatic stromal tumour of uncertain malignant potential, abbreviated PSTUMP, is a rare lesion of the prostatic stroma which cannot be definitively classified as benign or malignant.
It may be abbreviated as STUMP;[1] an abbreviation used for a uterine lesion of uncertain malignant potential.
It is also known as prostatic stromal proliferation of uncertain malignant potential (abbreviated PSPUMP).[2]
General
- Rare.
- Typically a good prognosis; however, there are some reports of progression to prostatic stromal sarcoma.[3]
- Wide age range (20s-80s) - but usually 50s and 60s.
Microscopic
Features:
- Overgrowth of spindle cells - "hypercellular stroma" - key feature.[1]
- +/-Atypical nuclei.[1]
- +/-Multinucleation.
- Lack prominent vessels - distinguishes from stromal nodule in BPH.[3]
Note:
- Do not have necrosis and no or minimal mitotic activity - important.[1]
- May be seen with glandular abnormalities.[4]
DDx:
- Stromal proliferation in benign prostatic hyperplasia.
- Prostatic stromal sarcoma.[1]
- Leiomyosarcoma.
- Rhabdomyosarcoma.
- Sarcomatoid prostate carcinoma - often associated with conventional prostate carcinoma & history of radiation.
Subclassification
May be subclassified as per Gaudin et al.:[2]
- Scattered atypical cells with benign glands.
- Minimal atypical cells.
- Leaf like growth pattern (phyllodes-like).
- Atypical cells without glands.
Images
STUMP - 1 (WC/Netto)
STUMP - 2 (WC/Netto)
www
IHC
Features:[1]
- ER +ve.
- PR +ve.
- Desmin +ve/-ve.
- CD34 +ve.
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 De Berardinis, E.; Busetto, GM.; Antonini, G.; Giovannone, R.; Di Placido, M.; Magliocca, FM.; Di Silverio, A.; Gentile, V. (2012). "Incidental prostatic stromal tumor of uncertain malignant potential (STUMP): histopathological and immunohistochemical findings.". Urologia 79 (1): 65-8. doi:10.5301/RU.2012.9099. PMID 22388992.
- ↑ 2.0 2.1 Gaudin, PB.; Rosai, J.; Epstein, JI. (Feb 1998). "Sarcomas and related proliferative lesions of specialized prostatic stroma: a clinicopathologic study of 22 cases.". Am J Surg Pathol 22 (2): 148-62. PMID 9500215.
- ↑ 3.0 3.1 Hansel, DE.; Herawi, M.; Montgomery, E.; Epstein, JI. (Jan 2007). "Spindle cell lesions of the adult prostate.". Mod Pathol 20 (1): 148-58. doi:10.1038/modpathol.3800676. PMID 17170745.
- ↑ Nagar, M.; Epstein, JI. (Jun 2011). "Epithelial proliferations in prostatic stromal tumors of uncertain malignant potential (STUMP).". Am J Surg Pathol 35 (6): 898-903. doi:10.1097/PAS.0b013e318214f2f2. PMID 21572264.
- ↑ Murer, LM.; Talmon, GA. (Nov 2014). "Stromal tumor of uncertain malignant potential of the prostate.". Arch Pathol Lab Med 138 (11): 1542-5. doi:10.5858/arpa.2013-0212-RS. PMID 25357117.