Prostatic intraepithelial neoplasia (PIN)
High grade PIN - Desquamating apoptotic pattern

Author: Nicholas Reder, M.D. (see Authors page)
Editor: Maria Tretiakova, M.D.

Revised: 1 October 2015, last major update October 2015

Copyright: (c) 2003-2015,, Inc.

PubMed Search: High grade prostatic intraepithelial neoplasia [title]
Cite this page: High grade PIN - Desquamating apoptotic pattern. website. Accessed March 20th, 2018.
Definition / general
  • An unusual form of HGPIN that meets several of the criteria of intraductal carcinoma of the prostate (IDC-P)
  • Not considered a separate pattern of HGPIN
  • Case reports
  • Desquamating apoptotic variant of high grade prostatic intraepithelial neoplasia (Hum Pathol 2011;42:892)
  • Microscopic (histologic) description
  • Complex large caliber glands admixed with smaller glands lined by tall columnar cells with marked atypia
  • Desquamating cells containing apoptotic nuclear material that coalesce in the gland lumens to form basophilic intraluminal amorphous material
  • Positive stains
  • Positive basal cell staining for 34βE12
  • Intraluminal cellular remnants are focally positive for epithelial cytokeratin (AE1/AE3)
  • Differential diagnosis
  • Cribriform HGPIN: Glands do not contain comedonecrosis or basophilic amorphous material, however could contain apoptotic bodies in 13% of cases (Hum Pathol 2005;36:1172)
  • Ductal carcinoma of the prostate: large expansile glands and papillae with true fibrovascular cores and lacking basal cells
  • Intraductal carcinoma of the prostate:
    • Dilated, large caliber glands with smooth contours that are filled with cytologically atypical cells and true comedonecrosis
    • Will often be associated with high grade and high volume invasive component (Mod Pathol 2006;19:1528)