Difference between revisions of "Intraductal carcinoma of the prostate"
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| Gross = | | Gross = | ||
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| Site = | | Site = [[prostate gland]] | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
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| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = uncommon | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
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*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> | *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. | **For comparison: HGPIN ~70% agreement, invasive carcinoma ~73% agreement. | ||
*Uncommon finding ~ 3% of cases in a series of 1176 prostate biopsies.<ref name=pmid23931616>{{Cite journal | last1 = Watts | first1 = K. | last2 = Li | first2 = J. | last3 = Magi-Galluzzi | first3 = C. | last4 = Zhou | first4 = M. | title = Incidence and clinicopathological characteristics of intraductal carcinoma detected in prostate biopsies: a prospective cohort study. | journal = Histopathology | volume = 63 | issue = 4 | pages = 574-9 | month = Oct | year = 2013 | doi = 10.1111/his.12198 | PMID = 23931616 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
Revision as of 04:56, 11 April 2015
| Intraductal carcinoma of the prostate | |
|---|---|
| Diagnosis in short | |
| Site | prostate gland |
|
| |
| Prevalence | uncommon |
Intraductal carcinoma of the prostate, abbreviated IDCP, is a proliferation of malignant prostate cells within glands that have an intact basal cell layer.
General
- May represent a precursor to invasive prostate carcinoma.[1]
- Associated with a poor prognosis.[2]
- Strong association with aggressive invasive carcinomas on prostatectomy when identified in isolation on biopsy.[3]
- High interobserver variability among experts ~43% agreement.[4]
- For comparison: HGPIN ~70% agreement, invasive carcinoma ~73% agreement.
- Uncommon finding ~ 3% of cases in a series of 1176 prostate biopsies.[5]
Microscopic
Major criteria
Required major criteria:[6][7]
- 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:[6]
- Comedonecrosis.
Minor criteria
Minor criteria:[6]
- 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
References
- ↑ Miyai, K.; Divatia, MK.; Shen, SS.; Miles, BJ.; Ayala, AG.; Ro, JY. (2014). "Heterogeneous clinicopathological features of intraductal carcinoma of the prostate: a comparison between "precursor-like" and "regular type" lesions.". Int J Clin Exp Pathol 7 (5): 2518-26. PMID 24966964.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Watts, K.; Li, J.; Magi-Galluzzi, C.; Zhou, M. (Oct 2013). "Incidence and clinicopathological characteristics of intraductal carcinoma detected in prostate biopsies: a prospective cohort study.". Histopathology 63 (4): 574-9. doi:10.1111/his.12198. PMID 23931616.
- ↑ 6.0 6.1 6.2 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.
- ↑ 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.