Synonyms
Intraductal dysplasia of the prostate (obsolete)
Definition
High-grade prostatic intraepithelial neoplasia (HGPIN) is a neoplastic proliferation of secretory cells within preexisting ducts and acini, with cytological changes resembling those seen in cancer. HGPIN is the most likely precursor of prostatic adenocarcinoma, according to virtually all available evidence.
Clinical Features
Incidence
The mean incidence of HGPIN in prostatic needle biopsies is about 5%.
Age
Patients aged 50–60 years.
Sex
Male.
Site
The most commonly location is in the peripheral zone of the prostate.
Treatment
Treatment is not indicated. Prophylactic RP or radiation is not an acceptable treatment. Patients with isolated HGPIN in needle biopsy may be considered for enrolment into clinical trials with chemoprevention agents. Men with a single core positive for HGPIN do not require routine repeat biopsy. In multifocal HGPIN, follow-up monitoring could include serum and urine tests or imaging.
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References and Further Reading
Bostwick, D. G., Amin, M. B., Dundore, P., et al. (1993). Architectural patterns of high-grade prostatic intraepithelial neoplasia. Human Pathology, 24, 298–310.
De Marzo, A. M., Haffner, M. C., Lotan, T. L., et al. (2016). Premalignancy in prostate cancer: Rethinking what we know. Cancer Prevention Research, 9, 648–656.
Epstein, J. I., & Herawi, M. (2006). Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: Implications for patient care. The Journal of Urology, 175 (Part 1), 820–834.
Herawi, M., Kahane, H., Cavallo, C., et al. (2006). 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. The Journal of Urology, 175, 121–124.
Moch, H., Humphrey, P. A., Ulbrigh, T. M., & Reutere, V. E. (Eds.). (2016). WHO classification of Tumours of the urinary system and male genital organs. Lyon: International Agency for Research on Cancer.
Montironi, R., Mazzucchelli, R., Lopez-Beltran, A., et al. (2011). Prostatic intraepithelial neoplasia: Its morphological and molecular diagnosis and clinical significance. BJU International, 108, 1394–1401.
Zhou, M. (2018). High-grade prostatic intraepithelial neoplasia, PIN-like carcinoma, ductal carcinoma, and intraductal carcinoma of the prostate. Modern Pathology, 31(S1), S71–S79.
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Cimadamore, A., Raspollini, M.R., Montironi, R. (2020). High-Grade Prostatic Intraepithelial Neoplasia. In: Raspollini, M.R., Lopez-Beltran, A. (eds) Uropathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-41894-6_4915
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DOI: https://doi.org/10.1007/978-3-030-41894-6_4915
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