Difference between revisions of "Intraductal carcinoma of the prostate"

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'''Intraductal carcinoma of the prostate''', abbreviated '''IDCP''', is a proliferation of [[malignant]] [[prostate gland|prostate]] cells within glands that have an intact basal cell layer.
'''Intraductal carcinoma of the prostate''', abbreviated '''IDCP''', is a proliferation of [[malignant]] [[prostate gland|prostate]] cells within glands that have an intact basal cell layer.


==General==
==General==
*May represent a precursor to invasive [[prostate carcinoma]].<ref name=pmid24966964>{{Cite journal  | last1 = Miyai | first1 = K. | last2 = Divatia | first2 = MK. | last3 = Shen | first3 = SS. | last4 = Miles | first4 = BJ. | last5 = Ayala | first5 = AG. | last6 = Ro | first6 = JY. | title = Heterogeneous clinicopathological features of intraductal carcinoma of the prostate: a comparison between "precursor-like" and "regular type" lesions. | journal = Int J Clin Exp Pathol | volume = 7 | issue = 5 | pages = 2518-26 | month =  | year = 2014 | doi =  | PMID = 24966964 }}</ref>
*Associated with a poor prognosis.<ref name=pmid19246509>{{Cite journal  | last1 = Henry | first1 = PC. | last2 = Evans | first2 = AJ. | title = Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications. | journal = J Clin Pathol | volume = 62 | issue = 7 | pages = 579-83 | month = Jul | year = 2009 | doi = 10.1136/jcp.2009.065003 | PMID = 19246509 }}</ref>
*Associated with a poor prognosis.<ref name=pmid19246509>{{Cite journal  | last1 = Henry | first1 = PC. | last2 = Evans | first2 = AJ. | title = Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications. | journal = J Clin Pathol | volume = 62 | issue = 7 | pages = 579-83 | month = Jul | year = 2009 | doi = 10.1136/jcp.2009.065003 | PMID = 19246509 }}</ref>
*Strong association with aggressive invasive carcinomas on prostatectomy when identified in isolation on biopsy.<ref name=pmid20723921>{{Cite journal  | last1 = Robinson | first1 = BD. | last2 = Epstein | first2 = JI. | title = Intraductal carcinoma of the prostate without invasive carcinoma on needle biopsy: emphasis on radical prostatectomy findings. | journal = J Urol | volume = 184 | issue = 4 | pages = 1328-33 | month = Oct | year = 2010 | doi = 10.1016/j.juro.2010.06.017 | PMID = 20723921 }}</ref>
*Strong association with aggressive invasive carcinomas on prostatectomy when identified in isolation on biopsy.<ref name=pmid20723921>{{Cite journal  | last1 = Robinson | first1 = BD. | last2 = Epstein | first2 = JI. | title = Intraductal carcinoma of the prostate without invasive carcinoma on needle biopsy: emphasis on radical prostatectomy findings. | journal = J Urol | volume = 184 | issue = 4 | pages = 1328-33 | month = Oct | year = 2010 | doi = 10.1016/j.juro.2010.06.017 | PMID = 20723921 }}</ref>

Revision as of 04:53, 11 April 2015

Intraductal carcinoma of the prostate
Diagnosis in short

Intraductal carcinoma of the prostate, abbreviated IDCP, is a proliferation of malignant prostate cells within glands that have an intact basal cell layer.

General

  • May represent a precursor to invasive prostate carcinoma.[1]
  • Associated with a poor prognosis.[2]
  • Strong association with aggressive invasive carcinomas on prostatectomy when identified in isolation on biopsy.[3]
  • High interobserver variability among experts ~43% agreement.[4]
    • For comparison: HGPIN ~70% agreement, invasive carcinoma ~73% agreement.

Microscopic

Major criteria

Required major criteria:[5][6]

  1. Glands 2x normal (peripheral zone) glands.
  2. Basal cells present (proven by IHC).
  3. "Cytologically malignant cells" = nuclear hyperchromasia, nuclear enlargement, nucleoli.
  4. Fills the lumen ("expansile") but does not have to be "solid".
    • Solid = no spaces between the cells.

Additional (major) criterion:[5]

Minor criteria

Minor criteria:[5]

  1. Branching of ducts at right angles.
  2. Rounded/smooth gland outlines.
  3. Two cell populations:
    • Malignant population (enlarged nuclei with hyperchromasia and nucleoli) = peripheral location in gland.
    • Benign population (smaller nuclei, no nucleoli) = central location in gland.

DDx:

IHC

Features - basal cells present:

  • CK34betaE12 +ve.
  • p63 +ve.

See also

References

  1. ↑ Miyai, K.; Divatia, MK.; Shen, SS.; Miles, BJ.; Ayala, AG.; Ro, JY. (2014). "Heterogeneous clinicopathological features of intraductal carcinoma of the prostate: a comparison between "precursor-like" and "regular type" lesions.". Int J Clin Exp Pathol 7 (5): 2518-26. PMID 24966964.
  2. ↑ Henry, PC.; Evans, AJ. (Jul 2009). "Intraductal carcinoma of the prostate: a distinct histopathological entity with important prognostic implications.". J Clin Pathol 62 (7): 579-83. doi:10.1136/jcp.2009.065003. PMID 19246509.
  3. ↑ Robinson, BD.; Epstein, JI. (Oct 2010). "Intraductal carcinoma of the prostate without invasive carcinoma on needle biopsy: emphasis on radical prostatectomy findings.". J Urol 184 (4): 1328-33. doi:10.1016/j.juro.2010.06.017. PMID 20723921.
  4. ↑ Iczkowski, KA.; Egevad, L.; Ma, J.; Harding-Jackson, N.; Algaba, F.; Billis, A.; Camparo, P.; Cheng, L. et al. (Dec 2014). "Intraductal carcinoma of the prostate: interobserver reproducibility survey of 39 urologic pathologists.". Ann Diagn Pathol 18 (6): 333-42. doi:10.1016/j.anndiagpath.2014.08.010. PMID 25263387.
  5. ↑ 5.0 5.1 5.2 Shah, RB.; Zhou, M. (Jul 2012). "Atypical cribriform lesions of the prostate: clinical significance, differential diagnosis and current concept of intraductal carcinoma of the prostate.". Adv Anat Pathol 19 (4): 270-8. doi:10.1097/PAP.0b013e31825c6c0e. PMID 22692290.
  6. ↑ Cohen, RJ.; Wheeler, TM.; Bonkhoff, H.; Rubin, MA. (Jul 2007). "A proposal on the identification, histologic reporting, and implications of intraductal prostatic carcinoma.". Arch Pathol Lab Med 131 (7): 1103-9. doi:10.1043/1543-2165(2007)131[1103:APOTIH]2.0.CO;2. PMID 17616999.
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