Atrophy of the prostate gland
|Atrophy of the prostate gland|
|Diagnosis in short|
Atrophic prostatic glands. H&E stain.
|LM||glands typically have a jagged edges/prows (in cancer the glands tend to have round edges), gland density is usually lower than in prostate carcinoma (glands are not back-to-back), nuclei small & hyperchromatic, scant cytoplasm|
|LM DDx||prostate carcinoma - esp. atrophic prostate carcinoma, atypical small acinar proliferation|
|IHC||AMACR -ve, p63 +ve (basal cells), CK34betaE12 +ve (basal cells)|
Atrophy of the prostate gland, also prostatic atrophy, is a common change in the prostate gland.
- Considered to be the most common mimicker of prostate carcinoma.
- Small glands - may mimic Gleason pattern 3.
- Inflammatory atrophy seems to be related to HGPIN and prostate cancer; however, the epidemiology is not compelling that this is a significant (clinical) association.
It can be classified into:
- Focal prostatic atrophy.
- Diffuse prostatic atrophy.
Focal atrophy can be subclassified as:
- Glands often have a jagged edges/prows (in cancer the glands tend to have round edges) - key feature.
- Gland density is usually lower than in prostate carcinoma, i.e. glands are not back-to-back - key feature.
- Atrophic glands are often hyperchromatic.
- Scant cytoplasm - usually.
- Nuclei like normal, i.e. nucleoli uncommon.
- Should have two cell layers, i.e. epithelial and myoepithelial (may be difficult to see).
- Atrophic glands may be scattered with non-atrophic ones.
- IHC may be misleading - basal cell loss.
- Atrophic prostate carcinoma.
- Atypical small acinar proliferation.
- Prostate carcinoma - focal, low grade.
Atrophy versus cancer
|angulated glands, may
look like they originate
from one large duct
|round glands, |
|Cytoplasm||scant/minimal||moderate, may |
|Basal cells||may be visible||absent|
|no||yes - eosinophilic |
- Atrophy (webpathology.com).
- Partial atrophy (webpathology.com).
- Sclerotic atrophy (webpathology.com).
- Classically like normal prostate (AMACR -ve, p63 +ve, CK34betaE12 +ve).
- May be negative for basal cell markers, i.e. p63 and CK34betaE12.
Generally, this finding is not reported; it is considered a normal finding.
Left Apex: - Benign prostate tissue with glandular atrophy.
The core shows rare, spaced, atrophic appearing glands, mostly with a wavy border and a decreased quantity of cytoplasm. Prominent nucleoli and significant nuclear enlargement are not identified.
There are none of the following: mitoses, adjacent PIN, suspicious luminal material, nuclear hyperchromasia.
- Wang, W.; Sun, X.; Epstein, JI. (Jun 2008). "Partial atrophy on prostate needle biopsy cores: a morphologic and immunohistochemical study.". Am J Surg Pathol 32 (6): 851-7. doi:10.1097/PAS.0b013e31815a0508. PMID 18408595. Cite error: Invalid
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- De Marzo, AM.; Marchi, VL.; Epstein, JI.; Nelson, WG. (Dec 1999). "Proliferative inflammatory atrophy of the prostate: implications for prostatic carcinogenesis.". Am J Pathol 155 (6): 1985-92. doi:10.1016/S0002-9440(10)65517-4. PMID 10595928.
- Celma, A.; Servián, P.; Planas, J.; Placer, J.; Quilez, MT.; Arbós, MA.; de Torres, I.; Morote, J. (Mar 2014). "Clinical Significance of Proliferative Inflammatory Atrophy in Prostate Biopsy.". Actas Urol Esp 38 (2): 122-126. doi:10.1016/j.acuro.2013.04.008. PMID 24129226.
- Billis, A.. "Prostatic atrophy. Clinicopathological significance.". Int Braz J Urol 36 (4): 401-9. PMID 20815946.
- SN. June 3, 2009.