Prostatic stromal tumour of uncertain malignant potential
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| Prostatic stromal tumour of uncertain malignant potential | |
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| Diagnosis in short | |
 Prostatic stromal tumour of uncertain malignant potential. (WC/George Netto) | |
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| Synonyms | prostatic stromal proliferation of uncertain malignant potential |
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| LM | increased stromal cellularity, +/-nuclear atypia, +/-benign glands, lack small round blood vessels, no necrosis, no or minimal mitotic activity |
| LM DDx | prostatic stromal sarcoma, stromal nodule in benign prostatic hyperplasia, leiomyosarcoma, rhabdomyosarcoma, sarcomatoid prostate carcinoma |
| IHC | CD34 +ve, ER +ve, PR +ve, vimentin +ve, panker -ve[citation needed] |
| Site | prostate gland |
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| Clinical history | 20s-80s - typically 50s and 60s |
| Prevalence | very rare |
| Prognosis | usually good |
| Clin. DDx | other tumours of the prostate, benign prostate, BPH |
Prostatic stromal tumour of uncertain malignant potential, abbreviated PSTUMP, is a rare lesion of the prostatic stroma which cannot be definitively classified as benign or malignant.
It may be abbreviated as STUMP;[1] an abbreviation used for a uterine lesion of uncertain malignant potential.
It is also known as prostatic stromal proliferation of uncertain malignant potential (abbreviated PSPUMP).[2]
General
- Rare.
- Typically a good prognosis; however, there are some reports of progression to prostatic stromal sarcoma.[3]
- Wide age range (20s-80s) - but usually 50s and 60s.
Microscopic
Features:
- Overgrowth of spindle cells - "hypercellular stroma" - key feature.[1]
- +/-Atypical nuclei.[1]
- +/-Multinucleation.
- Lack prominent vessels - distinguishes from stromal nodule in BPH.[3]
Note:
- Do not have necrosis and no or minimal mitotic activity - important.[1]
- May be seen with glandular abnormalities.[4]
DDx:
- Stromal proliferation in benign prostatic hyperplasia.
- Prostatic stromal sarcoma.[1]
- Leiomyosarcoma.
- Rhabdomyosarcoma.
- Sarcomatoid prostate carcinoma - often associated with conventional prostate carcinoma & history of radiation.
Subclassification
May be subclassified as per Gaudin et al.:[2]
- Scattered atypical cells with benign glands.
- Minimal atypical cells.
- Leaf like growth pattern (phyllodes-like).
- Atypical cells without glands.
Images
STUMP - 1 (WC/Netto)
STUMP - 2 (WC/Netto)
www
IHC
Features:[1]
- ER +ve.
- PR +ve.
- Desmin +ve/-ve.
- CD34 +ve.
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 De Berardinis, E.; Busetto, GM.; Antonini, G.; Giovannone, R.; Di Placido, M.; Magliocca, FM.; Di Silverio, A.; Gentile, V. (2012). "Incidental prostatic stromal tumor of uncertain malignant potential (STUMP): histopathological and immunohistochemical findings.". Urologia 79 (1): 65-8. doi:10.5301/RU.2012.9099. PMID 22388992.
- ↑ 2.0 2.1 Gaudin, PB.; Rosai, J.; Epstein, JI. (Feb 1998). "Sarcomas and related proliferative lesions of specialized prostatic stroma: a clinicopathologic study of 22 cases.". Am J Surg Pathol 22 (2): 148-62. PMID 9500215.
- ↑ 3.0 3.1 Hansel, DE.; Herawi, M.; Montgomery, E.; Epstein, JI. (Jan 2007). "Spindle cell lesions of the adult prostate.". Mod Pathol 20 (1): 148-58. doi:10.1038/modpathol.3800676. PMID 17170745.
- ↑ Nagar, M.; Epstein, JI. (Jun 2011). "Epithelial proliferations in prostatic stromal tumors of uncertain malignant potential (STUMP).". Am J Surg Pathol 35 (6): 898-903. doi:10.1097/PAS.0b013e318214f2f2. PMID 21572264.
- ↑ Murer, LM.; Talmon, GA. (Nov 2014). "Stromal tumor of uncertain malignant potential of the prostate.". Arch Pathol Lab Med 138 (11): 1542-5. doi:10.5858/arpa.2013-0212-RS. PMID 25357117.