Atypical sclerosing adenosis of the prostate

A rare mimic of adenocarcinoma

Liang Cheng, David G. Bostwick

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Aims: Sclerosing adenosis of the prostate is a benign, small, acinar proliferation in dense spindle cell stroma, with a distinct immunohistochemical profiles. It is incidentally found in about 2% of transurethral resection specimens. The aim was to describe cases with significant cytological atypia mimicking cancer, which have not been previously reported. Methods and results: We describe five cases of sclerosing adenosis with significant cytological atypia, referred to as atypical sclerosing adenosis (ASA), which were initially considered suspicious or diagnostic of adenocarcinoma. Seven other cases of typical sclerosing adenosis were used as controls. All cases of typical and atypical sclerosing adenosis displayed an intact basal cell layer, which was immunoreactive for high-molecular-weight keratin, S100 protein, smooth muscle actin, and prostate-specific antigen, with no differences between ASA and the control group. Alpha-methylacyl-coenzyme A racemase was negative. Three of four cases of ASA had aneuploid DNA content by digital image analysis. All cases of typical sclerosing adenosis were diploid. During a mean follow-up of 33 months (range 5-73 months), none developed recurrence or prostatic cancer. Conclusions: ASA is an unusual small, acinar proliferation of the prostate that may be mistaken for adenocarcinoma, and should be distinguished from other mimics, including atypical adenomatous hyperplasia, mesonephric remnant hyperplasia, and post-atrophic hyperplasia. ASA is a benign lesion and aggressive treatment is unwarranted.

Original languageEnglish
Pages (from-to)627-631
Number of pages5
JournalHistopathology
Volume56
Issue number5
DOIs
StatePublished - Apr 2010

Fingerprint

Hyperplasia
Prostate
Adenocarcinoma
Racemases and Epimerases
S100 Proteins
Aneuploidy
Coenzyme A
Prostate-Specific Antigen
Keratins
Diploidy
Smooth Muscle
Actins
Prostatic Neoplasms
Molecular Weight
Recurrence
Control Groups
DNA
Neoplasms

Keywords

  • Adenosis (atypical adenomatous hyperplasia)
  • Cancer mimickers
  • Immunohistochemistry
  • Precursor
  • Prostate
  • Prostatic neoplasms
  • Sclerosing adenosis

ASJC Scopus subject areas

  • Histology
  • Pathology and Forensic Medicine

Cite this

Atypical sclerosing adenosis of the prostate : A rare mimic of adenocarcinoma. / Cheng, Liang; Bostwick, David G.

In: Histopathology, Vol. 56, No. 5, 04.2010, p. 627-631.

Research output: Contribution to journalArticle

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