Atypical glands, suspicious for malignancy
Reviewers: Komal Arora, M.D., (see Reviewers page)
Revised: 26 March 2012, last major update February 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.
● Diagnosed in ~5% of biopsies; due to enlarged nucleoli (100%), enlarged nuclei (83%); intraluminal eosinophilic secretions (74%); infiltrative growth (68%); small acinar proliferation (68%); intraluminal basophilic mucin (42%); amphophilic cytoplasm (33%); high-grade PIN (31%); crystalloids (22%)
● Diagnosis of malignancy not made due to small size of the focus, small number of cells with enlarged nucleoli, clustered growth pattern, presence of high-grade PIN within many foci
● 60% with additional sampling had adenocarcinoma, suggesting need for additional biopsies (Am J Surg Pathol 1997;21:1489, J Urol 2001;166:866, BJU Int 2007;99:49)
● Be particularly cautious if small atypical glands plus a few neutrophils
● Following an atypical diagnosis, the routine recommendation (regardless of the PSA) is to sample 3 cores from the site of the initial atypical sextant site, 2 cores from the adjacent atypical sextant sites; and 1 core from other sextant sites (Mod Pathol 2004;17:307)
● Most tumors outside central zone are multifocal (75%+) in radical prostatectomies
● Note: Fibroblastic nuclei surrounding obvious cancer may mimic basal cells
End of Prostate > Prostatic carcinoma > Atypical glands, suspicious for malignancy
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