Partial atrophy in prostate needle biopsies: A detailed analysis of its morphology, immunophenotype, and cellular kinetics

Christopher G. Przybycin, Lakshmi P. Kunju, Angela J. Wu, Rajal B. Shah

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

We systematically analyzed 73 prospectively collected partial atrophy (PA) foci from over 185 prostate needle biopsy cases to characterize them along 3 fronts: morphologic, as it can be a mimic of prostate cancer (PCa), immunohistochemical (basal cell markers and α-methyl acyl-CoA racemase), as it often shares the staining characteristics of PCa, and cellular kinetics (MIB-1 proliferation marker), as it belongs to the larger group of focal atrophy, some of which have been shown to be proliferative and associated with chronic inflammation. The following morphologic features were prominent at low magnification: small to mid-sized glands with circumscribed (70%) or disorganized growth pattern (30%), presence of stellate/undulated gland lumina (92%), associated few completely atrophic glands within the PA focus (97%), and scant apical but abundant lateral pale/clear cytoplasm similar to adjacent benign glands (100%). On higher magnification, 33% of foci contained micronucleoli, but all lacked nuclear enlargement (100%) or macronucleoli (100%), characteristic of PCa. No adjunctive features of PCa were seen. Patchy basal cell staining was observed in 52/71 (73%), whereas 4/71 (6%) were completely negative. α-methyl acyl-CoA racemase demonstrated variable expression, stronger than the benign glands in 7/72 (10%) foci. Associated pathology included PCa (42%), and complete atrophy (91%), distinct from PA foci. There was no difference between the mean proliferative index of the PA foci compared with the benign glands [5.5 (range 0 to 30) and 5.6 (range 0 to 31), respectively, P=0.97 by paired t test], as measured quantitatively by ChromaVision system. PA foci were rarely associated with inflammation (1%). Familiarity with these morphologic features and staining characteristics will allow its confident separation from cancer, especially in limited biopsy material. PA foci do not represent a spectrum of proliferative inflammatory atrophy, justifying its term.

Original languageEnglish (US)
Pages (from-to)58-64
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

Keywords

  • Immunohistochemistry
  • Partial atrophy
  • Proliferative index
  • Prostate needle biopsy

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'Partial atrophy in prostate needle biopsies: A detailed analysis of its morphology, immunophenotype, and cellular kinetics'. Together they form a unique fingerprint.

Cite this