High-grade prostatic intraepithelial neoplasia - Revision history

Michael at 17:21, 3 April 2024

2024-04-03T17:21:04Z

← Older revision		Revision as of 17:21, 3 April 2024
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	*Benign prostate - HGPIN has nuclear changes.		*Benign prostate - HGPIN has nuclear changes.
	**Central zone typically has small nucleoli;<ref>{{Cite journal \| last1 = Egevad \| first1 = L. \| title = Cytology of the central zone of the prostate. \| journal = Diagn Cytopathol \| volume = 28 \| issue = 5 \| pages = 239-44 \| month = May \| year = 2003 \| doi = 10.1002/dc.10275 \| PMID = 12722118 }}</ref> however, the glands are larger.		**Central zone typically has small nucleoli;<ref>{{Cite journal \| last1 = Egevad \| first1 = L. \| title = Cytology of the central zone of the prostate. \| journal = Diagn Cytopathol \| volume = 28 \| issue = 5 \| pages = 239-44 \| month = May \| year = 2003 \| doi = 10.1002/dc.10275 \| PMID = 12722118 }}</ref> however, the glands are larger.
			*[[Atypical intraductal proliferation]] - a [[waffle diagnosis]] when criteria insufficient for [[intraductal carcinoma of the prostate]].

	===HGPIN architecture===		===HGPIN architecture===

Michael at 17:14, 3 April 2024

2024-04-03T17:14:38Z

← Older revision		Revision as of 17:14, 3 April 2024
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	\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, flat)		\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, flat)
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only), [[atypical ~~ductal~~ proliferation]]		\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only), [[atypical intraductal proliferation]]
	\| Stains =		\| Stains =
	\| IHC = AMACR +ve, basal cells present (p63 +ve, CK34betaE12 +ve)		\| IHC = AMACR +ve, basal cells present (p63 +ve, CK34betaE12 +ve)

Michael at 17:13, 3 April 2024

2024-04-03T17:13:52Z

← Older revision		Revision as of 17:13, 3 April 2024
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	\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, flat)		\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, flat)
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only)		\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only), [[atypical ductal proliferation]]
	\| Stains =		\| Stains =
	\| IHC = AMACR +ve, basal cells present (p63 +ve, CK34betaE12 +ve)		\| IHC = AMACR +ve, basal cells present (p63 +ve, CK34betaE12 +ve)
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	Notes:		Notes:
	*The architectural pattern is '''not''' thought to have any prognostic significance; however, it may be useful for differentiating it from benign prostate.		*The architectural pattern is '''not''' thought to have any prognostic significance; however, it may be useful for differentiating it from benign prostate.
	*"Cribriform HGPIN" previously existed; it is now classified as [[atypical intraductal ~~prolifertion~~]].<ref name=pmid35758185>{{cite journal \|authors=Kench JG, Amin MB, Berney DM, Compérat EM, Cree IA, Gill AJ, Hartmann A, Menon S, Moch H, Netto GJ, Raspollini MR, Rubin MA, Tan PH, Tsuzuki T, Turjalic S, van der Kwast TH, Zhou M, Srigley JR \|title=WHO Classification of Tumours fifth edition: evolving issues in the classification, diagnosis, and prognostication of prostate cancer \|journal=Histopathology \|volume=81 \|issue=4 \|pages=447–458 \|date=October 2022 \|pmid=35758185 \|pmc=9542779 \|doi=10.1111/his.14711 \|url=}}</ref>		*"Cribriform HGPIN" previously existed; it is now classified as [[atypical intraductal proliferation]].<ref name=pmid35758185>{{cite journal \|authors=Kench JG, Amin MB, Berney DM, Compérat EM, Cree IA, Gill AJ, Hartmann A, Menon S, Moch H, Netto GJ, Raspollini MR, Rubin MA, Tan PH, Tsuzuki T, Turjalic S, van der Kwast TH, Zhou M, Srigley JR \|title=WHO Classification of Tumours fifth edition: evolving issues in the classification, diagnosis, and prognostication of prostate cancer \|journal=Histopathology \|volume=81 \|issue=4 \|pages=447–458 \|date=October 2022 \|pmid=35758185 \|pmc=9542779 \|doi=10.1111/his.14711 \|url=}}</ref>

	===Images===		===Images===

Michael at 17:12, 3 April 2024

2024-04-03T17:12:03Z

← Older revision		Revision as of 17:12, 3 April 2024
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	\| Caption = High-grade prostatic intraepithelial neoplasia. [[H&E stain]].		\| Caption = High-grade prostatic intraepithelial neoplasia. [[H&E stain]].
	\| Synonyms = prostatic intraepithelial neoplasia		\| Synonyms = prostatic intraepithelial neoplasia
	\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary~~, [[cribriform]]~~, flat)		\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, flat)
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only)		\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only)
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	*Tufting - common.		*Tufting - common.
	*Micropapillary - common.		*Micropapillary - common.
	*[[Cribriform]] - rare.

	~~Note~~:		Notes:
	*The architectural pattern is '''not''' thought to have any prognostic significance; however, it may be useful for differentiating it from benign prostate.		*The architectural pattern is '''not''' thought to have any prognostic significance; however, it may be useful for differentiating it from benign prostate.
			*"Cribriform HGPIN" previously existed; it is now classified as [[atypical intraductal prolifertion]].<ref name=pmid35758185>{{cite journal \|authors=Kench JG, Amin MB, Berney DM, Compérat EM, Cree IA, Gill AJ, Hartmann A, Menon S, Moch H, Netto GJ, Raspollini MR, Rubin MA, Tan PH, Tsuzuki T, Turjalic S, van der Kwast TH, Zhou M, Srigley JR \|title=WHO Classification of Tumours fifth edition: evolving issues in the classification, diagnosis, and prognostication of prostate cancer \|journal=Histopathology \|volume=81 \|issue=4 \|pages=447–458 \|date=October 2022 \|pmid=35758185 \|pmc=9542779 \|doi=10.1111/his.14711 \|url=}}</ref>

	===Images===		===Images===

Michael at 04:10, 31 October 2015

2015-10-31T04:10:20Z

← Older revision		Revision as of 04:10, 31 October 2015
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	\| Caption = High-grade prostatic intraepithelial neoplasia. [[H&E stain]].		\| Caption = High-grade prostatic intraepithelial neoplasia. [[H&E stain]].
	\| Synonyms = prostatic intraepithelial neoplasia		\| Synonyms = prostatic intraepithelial neoplasia
	\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, cribriform, flat)		\| Micro = nuclear changes (hyperchromatic nuclei, nucleoli present, +/-increased NC ratio, mild-to-moderate nuclear enlargement), medium-to-large glands with the architecture of HGPIN (tufted, micropapillary, [[cribriform]], flat)
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only)		\| LMDDx = [[basal cell hyperplasia]], [[prostatic adenocarcinoma]], [[PIN-like prostatic ductal adenocarcinoma]], [[atypical small acinar proliferation]] (biopsy only)
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	*Tufting - common.		*Tufting - common.
	*Micropapillary - common.		*Micropapillary - common.
	*Cribriform - rare.		*[[Cribriform]] - rare.

	Note:		Note:

Michael: expand

2015-03-17T18:02:45Z

expand

← Older revision		Revision as of 18:02, 17 March 2015
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	**Nucleoli present - '''key (high power) feature'''.		**Nucleoli present - '''key (high power) feature'''.
	**Often increased NC ratio.		**Often increased NC ratio.
	**Nuclear enlargement.		**Nuclear enlargement - usually subtle/appreciated at high magnification only.
			*Tinctorial changes of the cytoplasm - usually amphophilic (red) or basophilic (blue).

	Notes:		Notes:
	*Nucleoli should be visible with the 20x objective.		*[[Nucleoli]] should be visible with the 20x objective.
	**If one uses the 40x objective... one over calls.		**If one uses the 40x objective... one over calls.
	*May need IHC for cancer versus HGPIN.		*May need IHC for cancer versus HGPIN.
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	**[[PIN-like prostatic ductal adenocarcinoma]] - glands crowded.		**[[PIN-like prostatic ductal adenocarcinoma]] - glands crowded.
	*Benign prostate - HGPIN has nuclear changes.		*Benign prostate - HGPIN has nuclear changes.
			**Central zone typically has small nucleoli;<ref>{{Cite journal \| last1 = Egevad \| first1 = L. \| title = Cytology of the central zone of the prostate. \| journal = Diagn Cytopathol \| volume = 28 \| issue = 5 \| pages = 239-44 \| month = May \| year = 2003 \| doi = 10.1002/dc.10275 \| PMID = 12722118 }}</ref> however, the glands are larger.

	===HGPIN architecture===		===HGPIN architecture===

Michael: /* Microscopic */ fix typo

2015-03-17T17:13:02Z

Microscopic: fix typo

← Older revision		Revision as of 17:13, 17 March 2015
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	*[[Prostatic adenocarcinoma]] - glands with HGPIN have two or more distinct cells layers.		*[[Prostatic adenocarcinoma]] - glands with HGPIN have two or more distinct cells layers.
	**[[PIN-like prostatic ductal adenocarcinoma]] - glands crowded.		**[[PIN-like prostatic ductal adenocarcinoma]] - glands crowded.
	*Benign prostate - ~~HPGIN~~ has nuclear changes.		*Benign prostate - HGPIN has nuclear changes.

	===HGPIN architecture===		===HGPIN architecture===

Michael: /* General */

2014-09-25T18:45:31Z

General

← Older revision		Revision as of 18:45, 25 September 2014
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	*Multifocal HGPIN considered a risk for prostate cancer on re-biopsy.<ref name=pmid21191509>{{Cite journal \| last1 = Srigley \| first1 = JR. \| last2 = Merrimen \| first2 = JL. \| last3 = Jones \| first3 = G. \| last4 = Jamal \| first4 = M. \| title = Multifocal high-grade prostatic intraepithelial neoplasia is still a significant risk factor for adenocarcinoma. \| journal = Can Urol Assoc J \| volume = 4 \| issue = 6 \| pages = 434 \| month = Dec \| year = 2010 \| doi = \| PMID = 21191509 }}</ref><ref name=pmid19524976>{{Cite journal \| last1 = Merrimen \| first1 = JL. \| last2 = Jones \| first2 = G. \| last3 = Walker \| first3 = D. \| last4 = Leung \| first4 = CS. \| last5 = Kapusta \| first5 = LR. \| last6 = Srigley \| first6 = JR. \| title = Multifocal high grade prostatic intraepithelial neoplasia is a significant risk factor for prostatic adenocarcinoma. \| journal = J Urol \| volume = 182 \| issue = 2 \| pages = 485-90; discussion 490 \| month = Aug \| year = 2009 \| doi = 10.1016/j.juro.2009.04.016 \| PMID = 19524976 }}</ref>		*Multifocal HGPIN considered a risk for prostate cancer on re-biopsy.<ref name=pmid21191509>{{Cite journal \| last1 = Srigley \| first1 = JR. \| last2 = Merrimen \| first2 = JL. \| last3 = Jones \| first3 = G. \| last4 = Jamal \| first4 = M. \| title = Multifocal high-grade prostatic intraepithelial neoplasia is still a significant risk factor for adenocarcinoma. \| journal = Can Urol Assoc J \| volume = 4 \| issue = 6 \| pages = 434 \| month = Dec \| year = 2010 \| doi = \| PMID = 21191509 }}</ref><ref name=pmid19524976>{{Cite journal \| last1 = Merrimen \| first1 = JL. \| last2 = Jones \| first2 = G. \| last3 = Walker \| first3 = D. \| last4 = Leung \| first4 = CS. \| last5 = Kapusta \| first5 = LR. \| last6 = Srigley \| first6 = JR. \| title = Multifocal high grade prostatic intraepithelial neoplasia is a significant risk factor for prostatic adenocarcinoma. \| journal = J Urol \| volume = 182 \| issue = 2 \| pages = 485-90; discussion 490 \| month = Aug \| year = 2009 \| doi = 10.1016/j.juro.2009.04.016 \| PMID = 19524976 }}</ref>
	**A small focus of HGPIN does not appear to be associated with an increased risk for prostate cancer on re-biopsy at one year if the initial biopsy had 8 or more cores.<ref name=pmid16406886>{{Cite journal \| last1 = Herawi \| first1 = M. \| last2 = Kahane \| first2 = H. \| last3 = Cavallo \| first3 = C. \| last4 = Epstein \| first4 = JI. \| title = Risk of prostate cancer on first re-biopsy within 1 year following a diagnosis of high grade prostatic intraepithelial neoplasia is related to the number of cores sampled. \| journal = J Urol \| volume = 175 \| issue = 1 \| pages = 121-4 \| month = Jan \| year = 2006 \| doi = 10.1016/S0022-5347(05)00064-9 \| PMID = 16406886 }}</ref>		**A small focus of HGPIN does not appear to be associated with an increased risk for prostate cancer on re-biopsy at one year if the initial biopsy had 8 or more cores.<ref name=pmid16406886>{{Cite journal \| last1 = Herawi \| first1 = M. \| last2 = Kahane \| first2 = H. \| last3 = Cavallo \| first3 = C. \| last4 = Epstein \| first4 = JI. \| title = Risk of prostate cancer on first re-biopsy within 1 year following a diagnosis of high grade prostatic intraepithelial neoplasia is related to the number of cores sampled. \| journal = J Urol \| volume = 175 \| issue = 1 \| pages = 121-4 \| month = Jan \| year = 2006 \| doi = 10.1016/S0022-5347(05)00064-9 \| PMID = 16406886 }}</ref>
			*Interrater variability is moderate (kappa ~ 0.45) for benign versus HGPIN.<ref name=pmid8832557>{{Cite journal \| last1 = Allam \| first1 = CK. \| last2 = Bostwick \| first2 = DG. \| last3 = Hayes \| first3 = JA. \| last4 = Upton \| first4 = MP. \| last5 = Wade \| first5 = GG. \| last6 = Domanowski \| first6 = GF. \| last7 = Klein \| first7 = MA. \| last8 = Boling \| first8 = EA. \| last9 = Stilmant \| first9 = MM. \| title = Interobserver variability in the diagnosis of high-grade prostatic intraepithelial neoplasia and adenocarcinoma. \| journal = Mod Pathol \| volume = 9 \| issue = 7 \| pages = 742-51 \| month = Jul \| year = 1996 \| doi = \| PMID = 8832557 }}</ref>

	Low-grade prostatic intraepithelial neoplasia:		Low-grade prostatic intraepithelial neoplasia:

Michael: /* Mostly lower case */

2014-09-18T19:27:35Z

Mostly lower case

← Older revision		Revision as of 19:27, 18 September 2014
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	F. Right Base:		F. Right Base:
	- Benign prostatic tissue		- Benign prostatic tissue
			</pre>

			<pre>
			Colour seen in tissue cores at sign-out: green
	</pre>		</pre>

Michael: /* Sign out */

2014-09-18T00:04:31Z

Sign out

← Older revision		Revision as of 00:04, 18 September 2014
Line 129:		Line 129:
	</pre>		</pre>

			===Mostly lower case===
			<pre>
			A. Left Apex:
			- Focal high grade prostatic intraepithelial neoplasia, chronic
			inflammation

			B. Left Middle Zone:
			- Benign prostatic tissue

			C. Left Base:
			- Benign prostatic tissue

			D. Right Apex:
			- Benign prostatic tissue

			E. Right Middle Zone:
			- Benign prostatic tissue

			F. Right Base:
			- Benign prostatic tissue
			</pre>

			===Comment for many cores with HGPIN===
	If there is (isolated) HGPIN in more than 3 or 4 cores:		If there is (isolated) HGPIN in more than 3 or 4 cores:
	<pre>		<pre>