Difference between revisions of "Intraductal carcinoma of the prostate"

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#redirect [[Prostate_cancer#Intraductal_carcinoma of the prostate]]
'''Intraductal carcinoma of the prostate''', abbreviated '''IDCP''', is a proliferation of malignant prostate cells within glands that have an intact basal cell layer.


==General==
*Associated with a poor prognosis.<ref name=pmid19246509>{{Cite journal  | last1 = Henry | first1 = PC. | last2 = Evans | first2 = AJ. | title = Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications. | journal = J Clin Pathol | volume = 62 | issue = 7 | pages = 579-83 | month = Jul | year = 2009 | doi = 10.1136/jcp.2009.065003 | PMID = 19246509 }}</ref>
*Strong association with aggressive invasive carcinomas on prostatectomy when identified in isolation on biopsy.<ref name=pmid20723921>{{Cite journal  | last1 = Robinson | first1 = BD. | last2 = Epstein | first2 = JI. | title = Intraductal carcinoma of the prostate without invasive carcinoma on needle biopsy: emphasis on radical prostatectomy findings. | journal = J Urol | volume = 184 | issue = 4 | pages = 1328-33 | month = Oct | year = 2010 | doi = 10.1016/j.juro.2010.06.017 | PMID = 20723921 }}</ref>
*High interobserver variability among experts ~43% agreement.<ref name=pmid25263387>{{Cite journal  | last1 = Iczkowski | first1 = KA. | last2 = Egevad | first2 = L. | last3 = Ma | first3 = J. | last4 = Harding-Jackson | first4 = N. | last5 = Algaba | first5 = F. | last6 = Billis | first6 = A. | last7 = Camparo | first7 = P. | last8 = Cheng | first8 = L. | last9 = Clouston | first9 = D. | title = Intraductal carcinoma of the prostate: interobserver reproducibility survey of 39 urologic pathologists. | journal = Ann Diagn Pathol | volume = 18 | issue = 6 | pages = 333-42 | month = Dec | year = 2014 | doi = 10.1016/j.anndiagpath.2014.08.010 | PMID = 25263387 }}</ref>
**For comparison: HGPIN ~70% agreement, invasive carcinoma ~73% agreement.
==Microscopic==
===Major criteria===
Required major criteria:<ref name=pmid22692290>{{Cite journal  | last1 = Shah | first1 = RB. | last2 = Zhou | first2 = M. | title = Atypical cribriform lesions of the prostate: clinical significance, differential diagnosis and current concept of intraductal carcinoma of the prostate. | journal = Adv Anat Pathol | volume = 19 | issue = 4 | pages = 270-8 | month = Jul | year = 2012 | doi = 10.1097/PAP.0b013e31825c6c0e | PMID = 22692290 }}</ref><ref name=pmid17616999>{{Cite journal  | last1 = Cohen | first1 = RJ. | last2 = Wheeler | first2 = TM. | last3 = Bonkhoff | first3 = H. | last4 = Rubin | first4 = MA. | title = A proposal on the identification, histologic reporting, and implications of intraductal prostatic carcinoma. | journal = Arch Pathol Lab Med | volume = 131 | issue = 7 | pages = 1103-9 | month = Jul | year = 2007 | doi = 10.1043/1543-2165(2007)131[1103:APOTIH]2.0.CO;2 | PMID = 17616999 }}</ref>
#Glands 2x normal (peripheral zone) glands.
#Basal cells present (proven by IHC).
#"Cytologically malignant cells" = nuclear hyperchromasia, nuclear enlargement, nucleoli.
#Fills the lumen ("expansile") but does not have to be "solid".
#*Solid = no spaces between the cells.
Additional (major) criterion:<ref name=pmid22692290/>
*Comedo[[necrosis]].
===Minor criteria===
Minor criteria:<ref name=pmid22692290/>
#Branching of ducts at right angles.
#Rounded/smooth gland outlines.
#Two cell populations:
#*Malignant population (enlarged nuclei with hyperchromasia and nucleoli) = peripheral location in gland.
#*Benign population (smaller nuclei, no nucleoli) = central location in gland.
DDx:
*[[High-grade prostatic intraepithelial neoplasia]] (HGPIN).
*Invasive [[prostate adenocarcinoma]].
==IHC==
Features - basal cells present:
*CK34betaE12 +ve.
*p63 +ve.
==See also==
*[[Intraductal carcinoma]].
*[[Prostate carcinoma]].
==References==
{{Reflist|2}}
[[Category:Prostate cancer]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 04:45, 11 April 2015

Intraductal carcinoma of the prostate, abbreviated IDCP, is a proliferation of malignant prostate cells within glands that have an intact basal cell layer.

General

  • Associated with a poor prognosis.[1]
  • Strong association with aggressive invasive carcinomas on prostatectomy when identified in isolation on biopsy.[2]
  • High interobserver variability among experts ~43% agreement.[3]
    • For comparison: HGPIN ~70% agreement, invasive carcinoma ~73% agreement.

Microscopic

Major criteria

Required major criteria:[4][5]

  1. Glands 2x normal (peripheral zone) glands.
  2. Basal cells present (proven by IHC).
  3. "Cytologically malignant cells" = nuclear hyperchromasia, nuclear enlargement, nucleoli.
  4. Fills the lumen ("expansile") but does not have to be "solid".
    • Solid = no spaces between the cells.

Additional (major) criterion:[4]

Minor criteria

Minor criteria:[4]

  1. Branching of ducts at right angles.
  2. Rounded/smooth gland outlines.
  3. Two cell populations:
    • Malignant population (enlarged nuclei with hyperchromasia and nucleoli) = peripheral location in gland.
    • Benign population (smaller nuclei, no nucleoli) = central location in gland.

DDx:

IHC

Features - basal cells present:

  • CK34betaE12 +ve.
  • p63 +ve.

See also

References

  1. ↑ Henry, PC.; Evans, AJ. (Jul 2009). "Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications.". J Clin Pathol 62 (7): 579-83. doi:10.1136/jcp.2009.065003. PMID 19246509.
  2. ↑ Robinson, BD.; Epstein, JI. (Oct 2010). "Intraductal carcinoma of the prostate without invasive carcinoma on needle biopsy: emphasis on radical prostatectomy findings.". J Urol 184 (4): 1328-33. doi:10.1016/j.juro.2010.06.017. PMID 20723921.
  3. ↑ Iczkowski, KA.; Egevad, L.; Ma, J.; Harding-Jackson, N.; Algaba, F.; Billis, A.; Camparo, P.; Cheng, L. et al. (Dec 2014). "Intraductal carcinoma of the prostate: interobserver reproducibility survey of 39 urologic pathologists.". Ann Diagn Pathol 18 (6): 333-42. doi:10.1016/j.anndiagpath.2014.08.010. PMID 25263387.
  4. ↑ 4.0 4.1 4.2 Shah, RB.; Zhou, M. (Jul 2012). "Atypical cribriform lesions of the prostate: clinical significance, differential diagnosis and current concept of intraductal carcinoma of the prostate.". Adv Anat Pathol 19 (4): 270-8. doi:10.1097/PAP.0b013e31825c6c0e. PMID 22692290.
  5. ↑ Cohen, RJ.; Wheeler, TM.; Bonkhoff, H.; Rubin, MA. (Jul 2007). "A proposal on the identification, histologic reporting, and implications of intraductal prostatic carcinoma.". Arch Pathol Lab Med 131 (7): 1103-9. doi:10.1043/1543-2165(2007)131[1103:APOTIH]2.0.CO;2. PMID 17616999.
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