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.

Intraductal Carcinoma of the Prostate

2012 ◽  
Vol 136 (4) ◽  
pp. 418-425 ◽  
Author(s):  
Brian Robinson ◽  
Cristina Magi-Galluzzi ◽  
Ming Zhou
Keyword(s):  
Prostate Cancer ◽  
Intraepithelial Neoplasia ◽  
High Volume ◽  
Intraductal Carcinoma ◽  
Definitive Treatment ◽  
Secretory Cells ◽  
High Grade ◽  
Carcinoma Of The Prostate ◽  
Prostate Biopsies ◽  
Genetic Features

Context.—Intraductal carcinoma of the prostate (IDC-P) is a distinct clinicopathologic entity, characterized by an expansile proliferation of secretory cells within prostatic ducts and acini that demonstrate marked architectural and cytologic atypia. Intraductal carcinoma of the prostate is strongly associated with high-grade and high-volume, invasive prostate cancer and a poorer prognosis than cases without IDC-P. Objective.—To review the historic perspectives, pathologic and genetic features, diagnostic criteria and differential diagnoses, and the clinical significance of IDC-P. Data Sources.—Relevant studies indexed in PubMed. Conclusions.—It is critical to recognize IDC-P, especially in prostate biopsies in which the clinical implications of IDC-P are greatest. Morphologic criteria have been proposed to distinguish IDC-P from several other lesions with similar histologic appearance such as high-grade prostatic intraepithelial neoplasia, invasive cribriform prostate cancer, and urothelial carcinoma involving the prostate. Intraductal carcinoma of the prostate is an uncommon finding in prostate biopsies, and it is even rarer as an isolated finding without concomitant prostate cancer in biopsies. However, patients with isolated IDC-P in biopsies are recommended for either definitive treatment or immediate repeat biopsy.

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

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.

Intraductal Carcinoma of the Prostate: Morphologic Features, Differential Diagnoses, Significance, and Reporting Practices

2015 ◽  
Vol 139 (10) ◽  
pp. 1234-1241 ◽  
Author(s):  
Martin Magers ◽  
Lakshmi Priya Kunju ◽  
Angela Wu
Keyword(s):  
Differential Diagnosis ◽  
Intraepithelial Neoplasia ◽  
Treatment Recommendations ◽  
Prostatic Intraepithelial Neoplasia ◽  
Differential Diagnoses ◽  
Intraductal Carcinoma ◽  
High Grade ◽  
Reporting Practices ◽  
Carcinoma Of The Prostate ◽  
Molecular Features

The differential diagnosis for atypical cribriform lesions of the prostate has become increasingly complex and includes intraductal carcinoma of the prostate, high-grade prostatic intraepithelial neoplasia, and atypical intraductal proliferations. In this review, we summarize the morphologic and molecular features and significance of intraductal carcinoma of the prostate. We also summarize our institution's strategy for reporting and treatment recommendations for intraductal carcinoma of the prostate.

scholarly journals Molecular Classification to Prognosticate Response in Medically Managed Endometrial Cancers and Endometrial Intraepithelial Neoplasia

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2847
Author(s):  
Allison M. Puechl ◽  
Daniel Spinosa ◽  
Andrew Berchuck ◽  
Angeles Alvarez Secord ◽  
Kerry E. Drury ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Single Gene ◽  
Intraepithelial Neoplasia ◽  
Molecular Classification ◽  
Definitive Treatment ◽  
Time To Progression ◽  
Endometrial Intraepithelial Neoplasia ◽  
Definitive Therapy ◽  
Patients At Risk ◽  
Endometrial Cancers

Background: The aim of this study was to evaluate whether molecular classification prognosticates treatment response in women with endometrial cancers and endometrial intraepithelial neoplasia (EIN) treated with levonorgestrel intrauterine system (LNG-IUS). Methods: Patients treated with LNG-IUS for endometrial cancer or EIN from 2013 to 2018 were evaluated. Using immunohistochemistry and single gene sequencing of POLE, patients were classified into four groups as per the Proactive Molecular Risk Classifier for Endometrial cancer (ProMisE): POLE-mutated, mismatch repair-deficient (MMRd), p53 wild type (p53wt), and p53-abnormal (p53abn). Groups were assessed relative to the primary outcome of progression or receipt of definitive treatment. Results: Fifty-eight subjects with endometrioid endometrial cancer or EIN treated with LNG-IUS were included. Of these, 22 subjects (37.9%) had endometrial cancer and 36 subjects (62.1%) had EIN. Per the ProMisE algorithm, 44 patients (75.9%) were classified as p53wt, 6 (10.3%) as MMRd, 4 (6.9%) as p53abn, and 4 (6.9%) as POLE-mutated. Of the 58 patients, 11 (19.0%) progressed or opted for definitive therapy. Median time to progression or definitive therapy was 7.5 months, with p53abn tumors having the shortest time to progression or definitive therapy. Conclusions: Molecular classification of endometrial cancer and EIN prior to management with LNG-IUS is feasible and may predict patients at risk of progression.

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