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pseudohyperplastic prostate adenocarcinoma

Sunday 12 February 2012

Pseudohyperplastic prostate cancer; pseudohyperplastic prostate acinar adenocarcinoma

Uncommonly, adenocarcinomas of the prostate share some architectural features with benign glands, including larger size, branching, and papillary infolding.

Pseudohyperplastic prostate cancer resembles benign prostate glands in that the neoplastic glands are large with branching and papillary infolding.

The recognition of cancer with this pattern is based on the architectural pattern of numerous closely packed glands as well as nuclear features more typical of carcinoma.

One pattern of pseudohyperplastic adenocarcinoma consists of numerous large glands that are almost back-to-back with straight even luminal borders, and abundant cytoplasm.

Comparably sized benign glands either have papillary infoldings or are atrophic.

The presence of cytologic atypia in some of these glands further distinguishes them from benign glands.

It is almost always helpful to verify pseudohyperplastic cancer with the use of immunohistochemistry to verify the absence of basal cells.

Pseudohyperplastic cancer, despite its benign appearance, may be associated with typical intermediate grade cancer and can exhibit aggressive behaviour (ie., extraprostatic extension).

Grading

These cancers should be graded as Gleason score 3+3=6 with pseudohyperplastic features.

This convention is in large part based on the recognition that they are most often accompanied by more ordinary Gleason score 3+3=6 adenocarcinoma.