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Difference between revisions of "High-grade prostatic intraepithelial neoplasia"
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High-grade prostatic intraepithelial neoplasia (view source)
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| Caption = High-grade prostatic intraepithelial neoplasia. [[H&E stain]]. | | Caption = High-grade prostatic intraepithelial neoplasia. [[H&E stain]]. | ||
| Synonyms = prostatic intraepithelial neoplasia | | Synonyms = prostatic intraepithelial neoplasia | ||
| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary | | Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, flat) | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only) | | LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only), [[atypical intraductal proliferation]] | ||
| Stains = | | Stains = | ||
| IHC = AMACR +ve, basal cells present (p63 +ve, CK34betaE12 +ve) | | IHC = AMACR +ve, basal cells present (p63 +ve, CK34betaE12 +ve) | ||
| Line 97: | Line 97: | ||
*Benign prostate - HGPIN has nuclear changes. | *Benign prostate - HGPIN has nuclear changes. | ||
**Central zone typically has small nucleoli;<ref>{{Cite journal | last1 = Egevad | first1 = L. | title = Cytology of the central zone of the prostate. | journal = Diagn Cytopathol | volume = 28 | issue = 5 | pages = 239-44 | month = May | year = 2003 | doi = 10.1002/dc.10275 | PMID = 12722118 }}</ref> however, the glands are larger. | **Central zone typically has small nucleoli;<ref>{{Cite journal | last1 = Egevad | first1 = L. | title = Cytology of the central zone of the prostate. | journal = Diagn Cytopathol | volume = 28 | issue = 5 | pages = 239-44 | month = May | year = 2003 | doi = 10.1002/dc.10275 | PMID = 12722118 }}</ref> however, the glands are larger. | ||
*[[Atypical intraductal proliferation]] - a [[waffle diagnosis]] when criteria insufficient for [[intraductal carcinoma of the prostate]]. | |||
===HGPIN architecture=== | ===HGPIN architecture=== | ||
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*Tufting - common. | *Tufting - common. | ||
*Micropapillary - common. | *Micropapillary - common. | ||
Notes: | |||
*The architectural pattern is '''not''' thought to have any prognostic significance; however, it may be useful for differentiating it from benign prostate. | *The architectural pattern is '''not''' thought to have any prognostic significance; however, it may be useful for differentiating it from benign prostate. | ||
*"Cribriform HGPIN" previously existed; it is now classified as [[atypical intraductal proliferation]].<ref name=pmid35758185>{{cite journal |authors=Kench JG, Amin MB, Berney DM, Compérat EM, Cree IA, Gill AJ, Hartmann A, Menon S, Moch H, Netto GJ, Raspollini MR, Rubin MA, Tan PH, Tsuzuki T, Turjalic S, van der Kwast TH, Zhou M, Srigley JR |title=WHO Classification of Tumours fifth edition: evolving issues in the classification, diagnosis, and prognostication of prostate cancer |journal=Histopathology |volume=81 |issue=4 |pages=447–458 |date=October 2022 |pmid=35758185 |pmc=9542779 |doi=10.1111/his.14711 |url=}}</ref> | |||
===Images=== | ===Images=== | ||