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Microscopic mimics of prostatic carcinoma

Postatrophic hyperplasia

Reviewers: Komal Arora, M.D., (see Reviewers page)
Revised: 22 May 2014, last major update July 2012
Copyright: (c) 2003-2014, PathologyOutlines.com, Inc.


● Also known as lobular atrophy
Simple atrophy: Large atrophic glands without crowding
Postatrophic hyperplasia: Crowded focus of small atrophic areas
● Relatively common, most often seen in peripheral zone of apex/mid prostate
● Associated with older age (Mod Pathol 1998;11:47)
● Not associated with adenocarcinoma although may mimic it (Am J Surg Pathol 1999;233:932, Arch Pathol Lab Med 2003;127:840)
● See also Am J Surg Pathol 2006;30:1281-more information

Micro description

● Atrophic and hyperplastic glands
● Maintenance of lobular architecture but scanty cytoplasm
● Glands stand out at low power due to basophilic appearance
● Basal layer usually present
● Associated with elastosis (basophilic tinge of stroma, Arch Pathol Lab Med 2000;124:1306), dilated gland with fibrosis often present in center of atrophic glands
● Glands show no evidence of active involution (Am J Surg Pathol 1998;22:1073)
● Chronic inflammation (32%), acute inflammation (21%), prominent nucleoli (14%), atrophy in adjacent areas; mitoses rare (1%), MIB staining in 3%

Micro images

Various images

Left: HMWCK + p63; right: HMWCK

Elastic stains

Positive stains

● Basal cells are 34βE12+ (Am J Surg Pathol 1999;23:925)

Differential diagnosis

Adenocarcinoma: usually has pale/amphophilic cytoplasm, basal nuclei, low nuclear to cytoplasmic ratio, CD10- if low grade (Am J Surg Pathol 1995;19:1068

End of Prostate > Microscopic mimics of prostatic carcinoma > Postatrophic hyperplasia

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