Histomorphological study of prostatic adenocarcinoma and its mimics

• Published in: Indian journal of pathology & microbiology 2019-04, Vol.62 (2), p.251-260
• Main Authors: Mahapatra, Qury, Mohanty, Pranati, Nanda, Annu, Mohanty, Lity
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - epidemiology; Adenocarcinoma - pathology; Adult; Age; Aged; Aged, 80 and over; Analysis; Antigens; Atrophy; Back pain; Benign; Biomarkers, Tumor; Biopsy; Cancer; Cancer surgery; Care and treatment; Diagnosis; Diagnosis, Differential; Histopathology; Humans; Hyperplasia; Immunohistochemistry; India - epidemiology; Lesions; Male; Middle Aged; mimics; Pathology; Prevalence; Prevalence studies (Epidemiology); Prospective Studies; Prostate; Prostate - pathology; prostate adenocarcinoma; Prostate cancer; Prostate-specific antigen; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Hyperplasia - diagnosis; Prostatic intraepithelial neoplasia; Prostatic Intraepithelial Neoplasia - diagnosis; Prostatic Intraepithelial Neoplasia - pathology; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - pathology; Rectum; Staining and Labeling; Surgery; Tumors
• ISSN: 0377-4929; 0974-5130
• DOI: 10.4103/IJPM.IJPM_322_18

Context: Prostate adenocarcinoma (PC) is one of the common cancers in India and world over. Numerous prostatic, nonprostatic lesions, and normal structures can be very similar to adenocarcinoma. A pathologist's awareness of the benign mimics is important for the diagnosis of PC. Aim: The aim of this study was to determine the prevalence, clinical, and histopathological features of PC, and its common mimics, and to study the criteria for their distinction from PC. Materials and Methods: A prospective study of histopathological features of radical prostatectomy and transurethral resection of the prostate specimens, sent to the department of pathology in a medical college, for a period of 2 years was done. A brief clinical history followed by a clinical examination, including per-rectal findings and serum prostate-specific antigen (PSA) levels, was noted. Results: After excluding all the cases of benign hyperplasia of prostate without any associated findings, 50 cases of operated surgical specimens of prostate were studied. PC was the most frequent diagnosis in 28 patients of 50 cases (56.0%). Basal cell hyperplasia formed the predominant mimic (26.0%), followed by prostatic intraepithelial neoplasia (8%), prostate atrophy (4%), clear-cell cribriform hyperplasia(4%),, and one case of atypical adenomatous hyperplasia (2%). Serum PSA was >4 ng/mL in all the cases of PC. In three of the mimics, PSA was >4 ng/mL and in the rest it was