Prostatic stromal tumour of uncertain malignant potential

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Prostatic stromal tumour of uncertain malignant potential
Diagnosis in short

Prostatic stromal tumour of uncertain malignant potential. (WC/George Netto)

Synonyms prostatic stromal proliferation of uncertain malignant potential

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

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:

Subclassification

May be subclassified as per Gaudin et al.:[2]

  1. Scattered atypical cells with benign glands.
  2. Minimal atypical cells.
  3. Leaf like growth pattern (phyllodes-like).
  4. Atypical cells without glands.

Images

www

IHC

Features:[1]

  • ER +ve.
  • PR +ve.
  • Desmin +ve/-ve.
  • CD34 +ve.

See also

References

  1. 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. 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. 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.
  4. 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.
  5. 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.