Ductal Spread Versus High-Grade Prostatic Intraepithelial Neoplasia: A Diagnostic Pitfall

Int J Surg Pathol. 2016 Dec;24(8):718-719. doi: 10.1177/1066896916668639. Epub 2016 Sep 7.

Abstract

Ductal spread (DS) of acinar adenocarcinoma of the prostate can lead to an incomplete replacement of the benign epithelium by cancer cells, resulting in a lesion that can be indistinguishable from high-grade prostatic intraepithelial neoplasia (HGPIN). Kovi and colleagues demonstrated 30 years ago that there is a significant association between the presence of DS and local extent of invasive adenocarcinoma, making the distinction between DS and HGPIN clinically relevant. However, despite the existence of certain morphologic features that are suggestive of DS, a definitive differentiation between the aforementioned lesions cannot always be attained.

Keywords: acinar adenocarcinoma; ductal spread; high-grade prostatic intraepithelial neoplasia; intraductal carcinoma; prostate.

MeSH terms

  • Carcinoma, Acinar Cell / diagnosis*
  • Carcinoma, Acinar Cell / pathology
  • Carcinoma, Ductal / diagnosis*
  • Carcinoma, Ductal / pathology
  • Humans
  • Male
  • Neoplasm Grading
  • Prostatic Intraepithelial Neoplasia / diagnosis*
  • Prostatic Intraepithelial Neoplasia / pathology
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / pathology