Author/Authors :
Arista-Nasr, Julián Department of Pathology - Instituto Nacional de Ciencias Médica y la Nutrición, S. Z. (INCMNSZ) - Tlalpan - México D.F, México , Martínez-Mijangos, omar Department of Pathology - Instituto Nacional de Ciencias Médica y la Nutrición, S. Z. (INCMNSZ) - Tlalpan - México D.F, México , Martínez-Benítez, Braulio Department of Pathology - Instituto Nacional de Ciencias Médica y la Nutrición, S. Z. (INCMNSZ) - Tlalpan - México D.F, México , Bornstein- Quevedo, leticia Department of Pathology - Instituto Nacional de Ciencias Médica y la Nutrición, S. Z. (INCMNSZ) - Tlalpan - México D.F, México , lino-Silva, Saul Departament of Pathology - Instituto Nacional de Cancerología (INCan) - México D. F., México , Urbina-Ramírez, Shaddaí Department of Pathology - Instituto Nacional de Ciencias Médica y la Nutrición, S. Z. (INCMNSZ) - Tlalpan - México D.F, México
Abstract :
Background: In surgical pathology, atypical small acinar proliferation is commonly detected
in prostate biopsies. Most studies on atypical small acinar proliferation have examined
morphological characteristics and the utility of immunohistochemical studies.
however, these resources are not available to many pathology departments. We have
found that examining additional sections is a simple and inexpensive method that allows
better evaluation of focal prostatic glandular atypia.
Objectives: The present report compares the diagnostic utility of immunohistochemical
techniques versus examining additional sections in prostate biopsies with focal glandular
atypia.
Patients and Methods: Thirty recently studied prostate biopsies with focal glandular atypia
were selected. In each case, 3 additional levels were examined. An immunohistochemical
study was performed on one level using an antibody against high-molecular-weight
keratin (34BetaE12). Two additional sections were stained with hematoxylin and eosin.
Results: The diagnosis of focal carcinoma was established with only additional sections
in 4 cases (13.3%). In 2 of these biopsies, additional areas of carcinoma were found that
were not identified in the original sections. In 4 other cases, immunohistochemical analysis
was the only useful method for diagnosing cancer. In 9 cases (30%), both methods
were useful for classifying focal glandular atypia as carcinoma. In the remaining 13 cases,
neither immunohistochemical analysis nor additional sections were useful in changing
the diagnosis of focal glandular atypia.
Conclusions: Focal glandular atypia in prostatic needle biopsies should be routinely examined
with additional sections, particularly when immunohistochemical analysis is
not possible. Some biopsies with atypical glandular proliferation may show focal carcinoma
in additional sections, even if the immunohistochemical analysis did not provide
a diagnosis of malignancy. Additional sections can also reveal areas of carcinoma that
were not apparent in the original sections.
Keywords :
Prostate , Biopsy , Needle Carcinoma , Neoplasm , Residual