NON-NEOPLASTIC LESIONS INCLUDING CANCER MIMICS IN BENIGN PROSTATIC HYPERPLASIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 89
Abstract
BACKGROUND Transurethral resection of prostate and prostatic biopsies are very common specimens in surgical pathology. Prostatic biopsies are done in cases where there is clinical suspicion of malignancy. These specimens have to be thoroughly examined to avoid false negative diagnosis of adenocarcinoma prostate. Morphological lesions in benign nodular hyperplasia that mimic adenocarcinoma can be broadly divided into those that mimic low-grade adenocarcinoma (Gleason grade ≤ 3) and those that mimic high-grade tumours. Non-neoplastic lesions which are to be distinguished from adenocarcinoma prostate are atrophy including partial atrophy, atypical adenomatous hyperplasia (adenosis), crowded benign glands, sclerosing adenosis, radiation atypia in benign glands, basal cell hyperplasia, clear cell hyperplasia, cribriform hyperplasia, non-specific granulomatous prostatitis, dense inflammation and malakoplakia, Signet ring-like change in non-epithelial cells, prostatic xanthoma and paraganglia. The aims of this study is to evaluate the spectrum of histomorphological lesions in benign nodular hyperplasia and to review the histomorphological features in cancer mimickers and how to distinguish them from adenocarcinoma prostate. The objective of this study is to evaluate and review the different cancer mimickers in benign nodular hyperplasia. MATERIALS AND METHODS It is a descriptive study from Jan. 2012 to Dec. 2014; 221 cases were identified in this period. All these cases were reviewed and incidence of various non-neoplastic lesions was evaluated. Statistical analysis was performed using SPSS 10.0 for Windows student version (SPSS Inc., 233 South Wacker Drive, 11th Floor, Chicago, IL 60606-6412). RESULTS Age of the patients ranged from 38 to 103 years. Common clinical presentation was obstructive symptoms (71.1%) and irritative symptoms (28.9%). Of the total 221 specimens, 203 were TURP specimens and 18 were open prostatectomy specimens. Incidence of various lesions was glandulostromal hyperplasia: 97.3%, stromal hyperplasia: 2.71%, corpora amylacea: 68%, cystically dilated glands: 92%, acute prostatitis: 1.2%, chronic prostatitis: 18.6%, papillary infoldings: 53.2%, proteinaceous material: 13.54%, infarct: 22%, gland necrosis: 4.22%, calcification: 0.82%, squamous metaplasia: 6%, transitional metaplasia: 2.5%, basal cell hyperplasia: 4.5%, cribriform hyperplasia: 0.45%, atrophy: 6%, post-atrophic hyperplasia: 25%, partial atrophy: 0.5%, atypical adenomatous hyperplasia: 8%, crowded benign glands: 96%, sclerosing adenosis: 1.5% and reactive epithelial atypia: 22%. CONCLUSION Histomorphological lesions in the differential diagnosis of adenocarcinoma prostate are atrophy including partial atrophy, atypical adenomatous hyperplasia, basal cell hyperplasia, cribriform hyperplasia and crowded benign glands. These lesions mimic adenocarcinoma prostate (Gleason grade ˂ 3).
Authors and Affiliations
Surinder Kumar Atr, Virender Mohan Rana, Monica Pangotra, Rahul Gupta
Keywords
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- EP ID EP277962
- DOI 10.14260/jemds/2017/1350
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