A Proposal on the Identification, Histologic Reporting, and Implications of Intraductal Prostatic Carcinoma

2007 ◽  
Vol 131 (7) ◽  
pp. 1103-1109
Author(s):  
Ronald J. Cohen ◽  
Thomas M. Wheeler ◽  
Helmut Bonkhoff ◽  
Mark A. Rubin
Keyword(s):  
Diagnostic Criteria ◽  
Prostate Carcinoma ◽  
Ductal Carcinoma ◽  
Intraepithelial Neoplasia ◽  
Intraductal Carcinoma ◽  
Published Data ◽  
Grading System ◽  
Basal Cells ◽  
Carcinoma Of The Prostate ◽  
Gleason Pattern

Abstract Context.—Prostatic adenocarcinoma growing within acinar-ductal spaces (intraductal carcinoma) in contrast to high-grade prostatic intraepithelial neoplasia (HG-PIN) impacts negatively on patient outcome. There is currently no generally accepted definition of this lesion nor is it classified in the current prostate cancer grading system (Gleason). Objective.—To define intraductal carcinoma of the prostate (IDC-P) with major and minor diagnostic criteria that clearly separate it from HG-PIN. The implications of such a lesion are discussed with proposals to incorporate this entity into the Gleason grading system. Data Sources.—We reviewed all published data referring to intraductal spread of prostate carcinoma. Articles discussing endometrial, endometrioid, and ductal carcinoma are included. Conclusions.—Intraductal carcinoma of the prostate as defined by major criteria that include enlarged gland structures, neoplastic cells spanning the gland lumen, central comedonecrosis, and further supported by minor diagnostic criteria including molecular biological markers, separate this entity from HG-PIN. Despite its perimeter basal cells, IDC-P should be interpreted as biologically equivalent to Gleason pattern 4 or 5 adenocarcinoma. Several hypotheses are proposed as to the evolution of IDC-P, which is almost always a late event in prostate carcinoma progression. Diagnosis of IDC-P on needle biopsy should prompt therapeutic intervention rather than surveillance or repeat biopsy, as is the case for HG-PIN.

scholarly journals Spectrum of Cribriform Proliferations of the Prostate: From Benign to Malignant

2018 ◽  
Vol 142 (8) ◽  
pp. 938-946 ◽  
Author(s):  
Thomas K. Lee ◽  
Jae Y. Ro
Keyword(s):  
Intraepithelial Neoplasia ◽  
Intraductal Carcinoma ◽  
Definitive Treatment ◽  
Diagnostic Challenge ◽  
Invasive Adenocarcinoma ◽  
Diagnostic Features ◽  
Carcinoma Of The Prostate ◽  
Gland Carcinoma ◽  
Malignant Lesions ◽  
The University

Context.— The presence of cribriform glands/ducts in the prostate can pose a diagnostic challenge. Cribriform glands/ducts include a spectrum of lesions, from benign to malignant, with vastly different clinical, prognostic, and treatment implications. Objective.— To highlight the diagnostic features of several entities with a common theme of cribriform architecture. We emphasize the importance of distinguishing among benign entities such as cribriform changes and premalignant to malignant entities such as high-grade prostatic intraepithelial neoplasia, atypical intraductal cribriform proliferation, intraductal carcinoma of the prostate, and invasive adenocarcinoma (acinar and ductal types). The diagnostic criteria, differential diagnosis, and clinical implications of these cribriform lesions are discussed. Data Sources.— Literature review of pertinent publications in PubMed up to calendar year 2017. Photomicrographs obtained from cases at the University of California at Irvine and authors' collections. Conclusions.— Although relatively uncommon compared with small acinar lesions (microacinar carcinoma and small gland carcinoma mimickers), large cribriform lesions are increasingly recognized and have become clinically and pathologically important. The spectrum of cribriform lesions includes benign, premalignant, and malignant lesions, and differentiating them can often be subtle and difficult. Intraductal carcinoma of the prostate in particular is independently associated with worse prognosis, and its presence in isolation should prompt definitive treatment. Patients with atypical intraductal cribriform proliferation, intraductal carcinoma of the prostate, or even focal cribriform pattern of invasive adenocarcinoma in biopsies would not be ideal candidates for active surveillance because of the high risk of adverse pathologic findings associated with these entities.

The presence of intraductal carcinoma of the prostate in needle biopsy as a prognostic parameter for prostate cancer patients with distant metastasis.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 237-237
Author(s):  
Masashi Kato ◽  
Toyonori Tsuzuki ◽  
Kyosuke Kimura ◽  
Naoto Sassa ◽  
Yasushi Yoshino ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Distant Metastasis ◽  
Needle Biopsy ◽  
Univariate Analysis ◽  
Intraductal Carcinoma ◽  
Prognostic Parameter ◽  
Carcinoma Of The Prostate ◽  
The Core ◽  
Gleason Pattern

237 Background: The presence of intraductal carcinoma of the prostate (IDC-P) is an adverse prognostic factor for prostate-specific antigen (PSA) failure, progression-free survival, and cancer-specific survival (CSS) in localized prostate cancer patients. However, there is no data indicating whether the presence of IDC-P can influence outcome in prostate cancer patients with distant metastasis at presentation. We aimed to evaluate whether IDC-P in needle biopsies is also an adverse prognostic parameter for CSS in prostate cancer patients with distant metastasis. Methods: We retrospectively evaluated 159 prostate cancer patients with distant metastasis who presented at the hospitals that the authors are affiliated with between 2002 and 2012 and reviewed the slides prepared from prostate needle biopsy specimens. Data on the patient age, performance status, clinical T stage, serum PSA, C-reactive protein, alkaline phosphatase (ALP), hemoglobin (Hb), albumin, serum calcium, biopsy Gleason score (> 8 or not), the presence of Gleason pattern 5, the percent of the core involved with cancer, and the maximum percent of a core involved with cancer were analyzed. Patient characteristics were analyzed using the Fisher's exact test. Multivariate Cox proportional hazard regression models were developed to predict CSS. Results: Patient median age was 73 years (range 47–90 years). The median serum PSA was 290 ng/mL (range 4.18–10,992 ng/mL). The median follow-up period was 36 months (range 3–120 months). IDC-P component was detected in 103 (64.8%) patients. There were 82 patients who died of the disease and 6 patients who died of other causes. Using univariate analysis, IDC-P (p = 0.0001), the presence of Gleason pattern 5 (p = 0.005), the percent of the core involved with cancer (p = 0.002), Hb (p = 0.001), and high ALP (p = 0.002) were all shown to be significantly associated with CSS. In the multivariate analysis, only IDC-P (p = 0.016; hazard ratio, 2.187) was significantly associated with CSS. Conclusions: The presence of IDC-P in needle biopsy is a prognostic parameter for CSS in patients with distant metastasis at presentation.

Presence of intraductal carcinoma of the prostate on needle biopsy as a prognostic factor for prostate cancer in radical prostatectomy patients.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 268-268
Author(s):  
Masashi Kato
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Needle Biopsy ◽  
Univariate Analysis ◽  
Intraductal Carcinoma ◽  
Carcinoma Of The Prostate ◽  
High Risk Prostate Cancer ◽  
Gleason Pattern ◽  
Risk Prostate Cancer

268 Background: Intraductal carcinoma of the prostate (IDCP) is seen with widely invasive, biologically aggressive prostate cancer. A recent study has shown this morphologic pattern is useful for prognostication of biochemical recurrence after radical prostatectomy, whereas there is no paper to report biopsy finding of IDCP to be a positive predictor of progression-free survival (PFS) and cancer-specific survival (CSS). Methods: This retrospective study included men with high-risk prostate cancer treated with radical prostatectomy between 1991 and 2005, and we reviewed slides of biopsy samples. Presence of IDCP was defined using previously published diagnostic criteria by a single genitourinary pathologist. Analyzed factors included age, prostate-specific antigen (PSA), clinical T stage, higher biopsy Gleason score (bGS), presence of Gleason pattern five, and IDCP on biopsy samples. Finally, a total of 205 patients with high-risk prostate cancer were entered in our retrospective clinicopathological analysis. Results: Patient mean age was 68. Baseline characteristics included a PSA greater than 20 ng/ml at diagnosis in 122 cases (60%), clinical stage greater than T2 (cT) in 86 (42%), and bGS ³a8 in 150 (73%) in all patients. Follow-up period was 86 months on average. The presence of IDCP on needle biopsy was in 75 (37%). Forty-four patients showed clinical failure, and 20 patients died of the disease. Patients with IDCP showed a higher increased PSA level, higher increased bGS, and more advanced cT than those without IDCP (p < 0.0001). In univariate analysis, IDCP (p < 0.0001), cT (p < 0.0001), bGS (p = 0.0002), and presence of Gleason pattern five (p=0.004) were significantly associated with PFS; IDCP (p < 0.001) and cT (p = 0.02) were significantly associated with CSS. In multivariate analysis, IDCP (p< 0.0001; hazard ratio (HR), 3.574) and cT (p= 0.004; HR, 3.087) were significantly associated with PFS; IDCP (p = 0.001; HR, 8.405) and PSA level (p = 0.0044; HR, 2.920) were significantly associated with CSS. Conclusions: Presence of IDCP on needle biopsy can be a significant predictor of PFS and CSS when analyzing factors of biopsy samples in high risk prostate cancer.

Intraductal Carcinoma of the Prostate Gland With Transmucosal Spread to the Seminal Vesicle: A Lesion Distinct From High-Grade Prostatic Intraepithelial Neoplasia

2007 ◽  
Vol 131 (7) ◽  
pp. 1122-1125 ◽  
Author(s):  
Ronald J. Cohen ◽  
Beverly A. Shannon ◽  
Sydney L. Weinstein
Keyword(s):  
Seminal Vesicle ◽  
Invasive Carcinoma ◽  
Prostate Gland ◽  
Ejaculatory Duct ◽  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Intraductal Carcinoma ◽  
High Grade ◽  
Carcinoma Of The Prostate ◽  
High Stage

Abstract Intraductal carcinoma of the prostate (IDC-P) gland represents an intraluminal neoplastic proliferation that is distinct from high-grade prostatic intraepithelial neoplasia (HG-PIN) and almost always coexists with large-volume, high-stage, and high-grade invasive carcinoma. We document an unusual presentation of apparently “early” IDC-P without an aggressive invasive element that, despite being confined to the acinar-ductal system, has gained access to the ejaculatory duct and seminal vesicle by transmucosal spread. This finding confirms that IDC-P, in contrast to HG-PIN, is inherently aggressive and has the ability to spread beyond the prostate gland. In this case, the absence of an aggressive invasive element suggests that IDC-P has most likely evolved within the lumens directly from HG-PIN.

scholarly journals Cytoplasmic PTEN protein loss distinguishes intraductal carcinoma of the prostate from high-grade prostatic intraepithelial neoplasia

2012 ◽  
Vol 26 (4) ◽  
pp. 587-603 ◽  
Author(s):  
Tamara L Lotan ◽  
Berrak Gumuskaya ◽  
Hameed Rahimi ◽  
Jessica L Hicks ◽  
Tsuyoshi Iwata ◽  
...  
Keyword(s):  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Intraductal Carcinoma ◽  
High Grade ◽  
Protein Loss ◽  
Pten Protein ◽  
Carcinoma Of The Prostate

Do Not Misinterpret Intraductal Carcinoma of the Prostate as High-grade Prostatic Intraepithelial Neoplasia!

2012 ◽  
Vol 62 (3) ◽  
pp. 518-522 ◽  
Author(s):  
Rodolfo Montironi ◽  
Marina Scarpelli ◽  
Liang Cheng ◽  
Antonio Lopez-Beltran ◽  
Ming Zhou ◽  
...  
Keyword(s):  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Intraductal Carcinoma ◽  
High Grade ◽  
Carcinoma Of The Prostate

scholarly journals Metastatic ductal carcinoma of the prostate: a rare variant responding to a common treatment

2013 ◽  
Vol 4 (2) ◽  
pp. 50 ◽  
Author(s):  
Aalok Kumar ◽  
Som Dave Mukherjee
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Rare Variant ◽  
Prostate Carcinoma ◽  
Poor Prognosis ◽  
Ductal Carcinoma ◽  
Prostate Adenocarcinoma ◽  
Histologic Subtype ◽  
Carcinoma Of The Prostate ◽  
Docetaxel Chemotherapy

Ductal carcinoma of the prostate is a rare histologic subtype ofprostate carcinoma. It represents 0.4% to 0.8% of all prostatecancers and is associated with a poor prognosis. Given the paucityof cases reported in the literature on ductal prostate carcinoma,little is known about how this cancer responds to cytotoxicchemotherapy. We report the case of a 56-year-old male whopresented to our clinic with hemoptysis, cough and hematuriaand was found to have metastatic ductal carcinoma of the prostate.He was initiated on docetaxel chemotherapy, which has beenpreviously shown to improve overall survival in patients withmetastatic prostate adenocarcinoma, but has never been studiedin this less common subtype of prostate cancer. To the best ofour knowledge, the following is the first reported case of a patientwith metastatic ductal carcinoma of the prostate responding todocetaxel chemotherapy.

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