Peculiarities of pathomorphological diagnostics of prostate gland adenosis and presentation of clinical case

Abstract

Background. Atypical adenomatous hyperplasia (AAH) or adenosis of the prostate gland is a pseudoneoplastic process which according to its tissue-architectural and cytological morphological peculiarities often resemble small acinar adenocarcinoma. In modern specialized literature few clinical-morphological peculiarities related to both pathological processes AAH and prostate adenocarcinoma (PA) were described. First, the incidence of AAH increases with age, as does the incidence of PA. Second, AAH lesions are often multifocal, as is PA, and they are located very closely to cancer areas. Third, the incidence of AAH increases in the presence of cancer and, vice versa, cancer incidence increases in cases of diagnosed AAH. Fourth, there are numbers of morphological changes, typical for AAH, which are closely related to highly differentiated PA. Objective of current work is study, analysis and possibilities of application in practice of differential diagnostic criteria of AAH and small acinar carcinomas of the prostate. Methods. In the case proposed for consideration during primary histological examination of prostate gland biopsy taken from 74-year old man AAH was detected. Results and conclusion. However, certain pathomorphological signs more typical for prostatic carcinomas, as well as results of immunohistochemical examination more characteristic for malignant epithelial adenogenous tumors served as the basis for verification of prostatic adenocarcinoma.