1/5. Foamy gland high-grade prostatic intraepithelial neoplasia.A 60-year-old man underwent radical prostatectomy for biopsy-proved adenocarcinoma of the prostate. Histologic examination of the entirely embedded prostatectomy specimen revealed extensive ordinary adenocarcinoma, Gleason's grade 3 3 = 6, involving both sides of the gland, and extending into extraprostatic soft tissue at the left base. Adjacent to the carcinoma, and separately, extensive high-grade prostatic intraepithelial neoplasia (PIN) was identified, much of which showed bland nuclei and abundant xanthomatous cytoplasm, identical morphologically to that seen in foamy gland prostate carcinoma. However, unlike foamy gland carcinoma, the foamy glands in the current patient were large, showed papillary infolding, and were associated with a discontinuous layer of basal cells, demonstrated by immunostaining for high-molecular weight cytokeratin. No invasive foamy gland carcinoma was identified in the prostatectomy specimen. Immunostains for Ki-67 showed an increased proliferation rate in foamy high-grade PIN glands when compared with adjacent benign glands. review of additional outside biopsy material revealed foamy gland high-grade PIN on four of seven needle cores, two of which showed no carcinoma. This patient demonstrates a new subtype of high-grade PIN that is difficult to recognize on needle biopsy. It is important to distinguish foamy gland high-grade PIN from its infiltrating counterpart, and it is critical to recognize because of the association of high-grade PIN with prostate carcinoma.- - - - - - - - - - ranking = 1keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
2/5. Radical prostatectomy for high grade prostatic intraepithelial neoplasia.High Grade prostatic intraepithelial neoplasia (HGPIN) has been recognized as the most likely precursor of invasive carcinoma of the prostate. Close surveillance and follow-up are indicated if subsequent procedures fail to identify carcinoma. There is still considerable controversy about the natural history of high grade PIN and most authors agree that its identification should not influence or dictate therapeutic decisions. We performed a prophylactic radical prostatectomy in such a case which has not been reported in the world literature.- - - - - - - - - - ranking = 0.8keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
3/5. Multilocular prostatic cystadenoma with high-grade prostatic intraepithelial neoplasia.Multilocular prostatic cystadenoma is a rarely encountered neoplasm located in the midline between the bladder and rectum that is either attached to the prostate by a pedicle or separate from the prostate entirely. Histologically and immunohistochemically these lesions resemble benign prostate tissue. We report the first case of this entity for which multifocal high-grade prostatic intraepithelial neoplasia (PIN) is identified. Conceptually, the finding of high-grade PIN in multilocular prostatic cystadenomas provides further evidence that these lesions are fully analogous to the prostate gland not only in their morphology and immunohistochemistry but also in their predilection for the same diseases.- - - - - - - - - - ranking = 1keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
4/5. High grade prostatic intraepithelial neoplasia with squamous differentiation.An unusual variant of prostatic intraepithelial neoplasia with prominent and extensive squamous differentiation is described. The lesion was identified in the transition zone of a 79 year old man with a three year history of increasing urinary obstructive symptoms and a clinical diagnosis of benign prostatic hyperplasia who underwent simple prostatectomy. Two years after surgery, prostatic biopsies showed atrophy and mild chronic inflammation, with no evidence of malignancy. This unusual intraepithelial lesion seems not to have been described before and may represent a new variant of high grade prostatic intraepithelial neoplasia (HGPIN) with squamous differentiation.- - - - - - - - - - ranking = 1.2586715894781keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |
5/5. Prostate pathology case study seminar.Great strides have been made in the past decade in our understanding of the pathology of the prostate. Diagnostic criteria have been proposed, debated, and refined for a number of entities, including prostatic intraepithelial neoplasia, atypical adenomatous hyperplasia, basal cell proliferations, postatrophic hyperplasia, verumontanum mucosal gland hyperplasia, and numerous new variants of prostatic adenocarcinoma such as ductal adenocarcinoma, mucinous carcinoma, signet ring cell carcinoma, and lymphoepithelioma-like carcinoma. This report presents a series of case studies in prostate pathology which illustrate some of the contemporary issues which confront the pathologist and urologist.- - - - - - - - - - ranking = 0.2keywords = intraepithelial neoplasia, intraepithelial, neoplasia (Clic here for more details about this article) |