Stratified epithelium in prostatic adenocarcinoma: a mimic of high-grade prostatic intraepithelial neoplasia

Hameed, Omar; Humphrey, Peter A.
July 2006
Modern Pathology;Jul2006, Vol. 19 Issue 7, p899
Academic Journal
Typically glands of prostatic adenocarcinoma have a single cell lining, although stratification can be seen in invasive carcinomas with a cribriform architecture, including ductal carcinoma. The presence and diagnostic significance of stratified cells within non-cribriform carcinomatous prostatic glands has not been well addressed. The histomorphological features and immunohistochemical profile of cases of non-cribriform prostatic adenocarcinoma with stratified malignant glandular epithelium were analyzed. These cases were identified from needle biopsy cases from the consultation files of one of the authors and from a review of 150 consecutive in-house needle biopsy cases of prostatic adenocarcinoma. Immunohistochemistry was performed utilizing antibodies reactive against high molecular weight cytokeratin (34βE12), p63 and α-methylacyl-coenzyme-A racemase (AMACR). A total of 8 cases were identified, including 2 from the 150 consecutive in-house cases (1.3%). In 4 cases, the focus with glands having stratified epithelium was the sole carcinomatous component in the biopsy, while such a component represented 5–30% of the invasive carcinoma seen elsewhere in the remaining cases. The main attribute in all these foci was the presence of glandular profiles lined by several layers of epithelial cells with cytological and architectural features resembling flat or tufted high-grade prostatic intraepithelial neoplasia, but lacking basal cells as confirmed by negative 34βE12 and/or p63 immunostains in all cases. The AMACR staining profile of the stratified foci was variable, with 4 foci showing positivity, and 3 foci being negative, including two cases that displayed AMACR positivity in adjacent non-stratified prostatic adenocarcinoma. Prostatic adenocarcinoma with stratified malignant glandular epithelium can be identified in prostate needle biopsy samples harboring non-cribriform prostatic adenocarcinoma and resembles glands with high-grade prostatic intraepithelial neoplasia. These ‘PIN-like’ carcinomas can present in pure form. Recognition of this pattern of prostatic adenocarcinoma is necessary to correctly diagnose such cases as invasive carcinoma.Modern Pathology (2006) 19, 899–906. doi:10.1038/modpathol.3800601; published online 7 April 2006


Related Articles

  • Diagnosis and reporting of limited adenocarcinoma of the prostate on needle biopsy. Epstein, Jonathan I. // Modern Pathology;Mar2004, Vol. 17 Issue 3, p307 

    The diagnosis of limited adenocarcinoma of the prostate is one of the more difficult challenges in surgical pathology. This paper highlights the methodological approach to diagnosing limited cancer, based on a constellation of features more commonly present in adenocarcinoma than benign glands....

  • Diagnosis of adenocarcinoma in prostate needle biopsy tissue.  // Journal of Clinical Pathology;Jan2007, Vol. 60 Issue 1, p35 

    Prostate cancer is a major public health problem throughout the developed world. For patients with clinically localised prostate cancer, the diagnosis is typically established by histopathological examination of prostate needle biopsy samples. Major and minor criteria are used to establish the...

  • PROSTATE CANCER DIAGNOSTICS WITH BIOPSY MATERIAL. Fedorina, T. A.; Poletaeva, S. V. // Saratov Journal of Medical Scientific Research / Saratovskii Nau;Oct-Dec2013, Vol. 9 Issue 4, p632 

    The aim of the article is to study the potential importance of specific location of biopsy of prostate cancer. Material and methods. Histological material from 700 patients has been examinated. 580 specimen of radical prostatectomy were examined. TRUS-guided 12-cores biopsy has been performed in...

  • Interpretation Of Prostatic Biopsies: A Review. Chitale, A.; Khubchandani, S. // Internet Journal of Urology;2005, Vol. 3 Issue 1, p5 

    The incidence of prostatic carcinoma is on the rise in the Indian subcontinent. A definitive diagnosis of this disease is obtained on a TRUS guided needle biopsy. Interpretation of these small biopsies therefore plays a vital role in the management and prognosis of the disease. However every...

  • Immunohistochemical expression of SMAD4, CK19, and CA19-9 in fine needle aspiration samples of pancreatic adenocarcinoma: Utility and potential role. Zapata, Mauricio; Cohen, Cynthia; Siddiqui, Momin T. // CytoJournal;2007, Vol. 4 Issue 1, p13 

    Background: Pancreatic adenocarcinoma comprises 85% of all cases of pancreatic malignancies. From a diagnostic standpoint, these tumors are readily diagnosed by fine needle aspiration, with an accuracy of greater than 90%; however it is often difficult to ascertain whether these are primary or...

  • Aspiration Cytomorphology of Fetal Adenocarcinoma of the Lung. Geisinger, Kim R.; Travis, William D.; Perkins, L. A.; Zakowski, Maureen F. // American Journal of Clinical Pathology;Dec2010, Vol. 134 Issue 6, p894 

    Fetal adenocarcinoma (FA) of the lung is an exceedingly rare malignancy. Many patients with the well-differentiated form are relatively young and with the high-grade variant are older. We describe the cases of 4 women with FA examined by fine-needle aspiration biopsy. Aspirates were moderately...

  • Needle Biopsy of Recurrent Adenocarcinoma of the Prostate After Radical Prostatectomy. Ripple, Mary G.; Potter, Steven R.; Partin, Alan W.; Epstein, Jonathan I. // Modern Pathology;May2000, Vol. 13 Issue 5, p521 

    The objective of this study was to evaluate needle biopsy of recurrent prostate cancer after radical prostatectomy. We evaluated 37 cases of recurrent prostate cancer after radical prostatectomy that were diagnosed by needle biopsy between March 1984 and July 1998. Fifteen were from...

  • Tissue print of prostate biopsy: a novel tool in the diagnostic procedure of prostate cancer. Angelucci, Adriano; Pace, Gianna; Sanità, Patrizia; Vicentini, Carlo; Bologna, Mauro // Diagnostic Pathology;2011, Vol. 6 Issue 1, p34 

    Background: Nowadays, the histological examination of prostate core needle biopsies is still regarded as the gold standard in the diagnosis of prostate cancer (PCa). We investigated if the tissue print of core needle biopsy (biopsy print) could be used as adjunctive molecular investigative...

  • Cytokeratin 19 Immunolocalization in Cell Block Preparation of Thyroid Aspirates. Khurana, Kamal K.; Truong, Luan D.; LiVolsi, Virginia A.; Baloch, Zubair W. // Archives of Pathology & Laboratory Medicine;May2003, Vol. 127 Issue 5, p579 

    Context.--Immunohistochemical staining for cytokeratin 19 (CK-19) is a useful ancillary technique for diagnosing papillary thyroid carcinoma (papillary carcinoma) in histologic specimens. Although similar results have been obtained on aspirate smears, to our knowledge the utility of CK-19...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics