Adenosis of the prostate gland

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Adenosis of the prostate gland
Diagnosis in short

Adenosis of prostate gland. H&E stain.

Synonyms atypical adenomatous hyperplasia

LM glandular crowding, bland nuclear features (lack prominent nucleoli, lack nuclear enlargement)
LM DDx prostatic adenocarcinoma (esp. foamy gland adenocarcinoma), bulbourethral gland
IHC patchy basal cell markers (e.g. p63 +ve, CK5/6 +ve), AMACR -ve, ERG -ve
Gross not evident
Site prostate gland - transistion zone

Prevalence common
Prognosis benign
Treatment none

Adenosis of the prostate gland, also adenosis of the prostate, is a benign change of the prostate gland, typically seen in the transistion zone of the prostate, and may be mistaken for (low grade) prostatic adenocarcinoma.[1]

It is also known as atypical adenomatous hyperplasia.[2][3]

General

Microscopic

Features:

  • Glandular crowding - key feature.
    • Glands may be back-to-back.
  • Lack of prominent nucleoli.

DDx:

Images

IHC

  • CK5/6 +ve. ‡
  • p63 +ve. ‡
  • AMACR -ve.
  • ERG -ve.[5]

Notes:

  • ‡ Often patchy - some glands in a group may lack basal cells.

Images

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  • Typically not reported explicitly.
  • IHC should be reported if done.

See also

References

  1. 1.0 1.1 Gaudin, PB.; Epstein, JI. (Jul 1995). "Adenosis of the prostate. Histologic features in needle biopsy specimens.". Am J Surg Pathol 19 (7): 737-47. PMID 7793471.
  2. Molinié, V.; Vadrot, J.; Duchatelle, V.; Balaton, A.; Abbey-Tobby, A.; Baumert, H. (Apr 2012). "[Diagnostic issues of prostate biopsies. Case 2. Atypical adenomatous hyperplasia (adenosis)].". Ann Pathol 32 (2): 114-7. doi:10.1016/j.annpat.2012.02.003. PMID 22520603.
  3. Humphrey, PA. (Dec 2012). "Atypical adenomatous hyperplasia (adenosis) of the prostate.". J Urol 188 (6): 2371-2. doi:10.1016/j.juro.2012.09.058. PMID 23000851.
  4. Epstein, JI. (Jan 2012). "Diagnosis of limited adenocarcinoma of the prostate.". Histopathology 60 (1): 28-40. doi:10.1111/j.1365-2559.2011.03990.x. PMID 22212076.
  5. 5.0 5.1 Green, WM.; Hicks, JL.; De Marzo, A.; Illei, PP.; Epstein, JI. (Sep 2013). "Immunohistochemical evaluation of TMPRSS2-ERG gene fusion in adenosis of the prostate.". Hum Pathol 44 (9): 1895-901. doi:10.1016/j.humpath.2013.02.019. PMID 23664537.
  6. Cheng, L.; Bostwick, DG. (Apr 2010). "Atypical sclerosing adenosis of the prostate: a rare mimic of adenocarcinoma.". Histopathology 56 (5): 627-31. doi:10.1111/j.1365-2559.2010.03525.x. PMID 20459573.