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Atypical Small Acinar Proliferation

  • Living reference work entry
  • First Online:
Encyclopedia of Pathology

Part of the book series: Encyclopedia of Pathology ((EP))

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Synonyms

Prostate tissue with small focus of atypical glands

Definition

Atypical Small Acinar Proliferation (ASAP) suspicious for, but not diagnostic of, adenocarcinoma (Epstein and Herawi 2006; Montironi et al. 2006).

Clinical Features

  • Incidence

    5% of prostate biopsies

  • Age

    The same age as prostate cancer (mean 65.8 years (Range 44–80)).

  • Sex

    Male.

  • Sit

    All prostate zones.

  • Treatment

    Definitive therapy (either surgical or nonsurgical) discouraged. Repeat biopsy and follow-up (Borboroglu et al. 2001).

  • Outcome

    Risk of detection of carcinoma on needle core re-biopsy: 40%.

Microscopy

  • Focus of small size.

  • Small acinar proliferation.

  • Small number of cells with enlarged nucleoli.

  • No basal cells in the initial H&E-stained sections (Egevad et al. 2006; Epstein 1998; Epstein and Herawi 2006; Montironi et al. 2006).

Immunophenotype

Basal cell markers and racemase: The former are absent in prostate cancer and the latter is expressed in 80% of cancers (See differential diagnosis and specific items)...

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References and Further Reading

  • Borboroglu, P. G., Sur, R. L., Roberts, J. L., & Amling, C. L. (2001). Repeat biopsy strategy in patients with atypical small acinar proliferation or high grade prostatic intraepithelial neoplasia on initial prostate needle biopsy. The Journal of Urology, 166, 866–870.

    Article  CAS  Google Scholar 

  • Egevad, L., Allsbrook, W. C., & Epstein, J. I. (2006). Current practice of diagnosis and reporting of prostatic intraepithelial neoplasia and glandular atypia among genitourinary pathologists. Modern Pathology, 19, 180–185.

    Article  Google Scholar 

  • Epstein, J. I. (1998). Atypical small acinar proliferation of the prostate gland. American Journal of Surgical Pathology, 22, 1430–1431.

    Article  CAS  Google Scholar 

  • Epstein, J. I., & Herawi, M. (2006). Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: Implications for patient care. Journal of Urology, 175, 820–834.

    Article  Google Scholar 

  • Montironi, R., Scattoni, V., Mazzucchelli, R., Lopez-Beltran, A., Bostwick, D. G., & Montorsi, F. (2006). Atypical foci suspicious but not diagnostic of malignancy in prostate needle biopsies (also referred to as “atypical small acinar proliferation suspicious for but not diagnostic of malignancy”). European Urology, 50, 666–674.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Institute of Pathological Anatomy and Histopathology, Polytechnic University of the Marche Region (Ancona), Ancona, Italy

    Alessia Cimadamore, Silvia Gasparrini & Rodolfo Montironi

Authors
  1. Alessia Cimadamore
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  2. Silvia Gasparrini
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  3. Rodolfo Montironi
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Corresponding author

Correspondence to Rodolfo Montironi .

Editor information

Editors and Affiliations

  1. NIJMEGEN, The Netherlands

    J.H.J.M. van Krieken

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Cimadamore, A., Gasparrini, S., Montironi, R. (2019). Atypical Small Acinar Proliferation. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_4782-1

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  • DOI: https://doi.org/10.1007/978-3-319-28845-1_4782-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-28845-1

  • Online ISBN: 978-3-319-28845-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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