2020 Edition
| Editors: Maria Rosaria Raspollini, Antonio Lopez-Beltran

High-Grade Prostatic Intraepithelial Neoplasia

  • Alessia Cimadamore
  • Maria Rosaria Raspollini
  • Rodolfo MontironiEmail author
Reference work entry
DOI: https://doi.org/10.1007/978-3-030-41894-6_4915


Intraductal dysplasia of the prostate (obsolete)


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


  • 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.

  • Outcome


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References and Further Reading

  1. Bostwick, D. G., Amin, M. B., Dundore, P., et al. (1993). Architectural patterns of high-grade prostatic intraepithelial neoplasia. Human Pathology, 24, 298–310.CrossRefGoogle Scholar
  2. 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.CrossRefGoogle Scholar
  3. 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.CrossRefGoogle Scholar
  4. 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.CrossRefGoogle Scholar
  5. 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.Google Scholar
  6. 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.CrossRefGoogle Scholar
  7. 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.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Alessia Cimadamore
    • 1
  • Maria Rosaria Raspollini
    • 2
  • Rodolfo Montironi
    • 1
    Email author
  1. 1.Institute of Pathological Anatomy and HistopathologyPolytechnic University of the Marche Region (Ancona), United Hospitals AnconaAnconaItaly
  2. 2.Histopathology and Molecular DiagnosticsUniversity Hospital CareggiFlorenceItaly