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Morphological identification of the patterns of prostatic intraepithelial neoplasia and their importance

Rodolfo Montironi¹, Roberta Mazzucchelli¹, Ferran Algaba² and Antonio Lopez-Beltran³

¹ Institute of Pathological Anatomy and Histopathology, University of Ancona, Ospedale Regionale, I-60020 Torrette, Ancona, Italy
² Institute of Urology, Fundacio Puigvert, Hospital de la Santa Crue i Sant Pau, Universitat Autonoma de Barcelona, Cartagena 340-350, 08025 Barcelona, Spain
³ Unit of Anatomic Pathology, Cordoba University Medical School, Avda. Menendez Pidal s/n, 14071 Cordoba, Spain

Correspondence to:
Professor Montironi email: r.montironi{at}popcsi.unian.it

High grade prostatic intraepithelial neoplasia (PIN) is the most likely precursor of prostatic carcinoma. PIN has a high predictive value as a marker for carcinoma, and its identification in biopsy specimens warrants repeat biopsy for concurrent or subsequent carcinoma. The only methods of detection are biopsy and transurethral resection; PIN does not greatly raise the concentration of serum prostate specific antigen (PSA) or its derivatives, does not induce a palpable mass, and cannot be detected by ultrasound. Androgen deprivation decreases the prevalence and extent of PIN, suggesting that this form of treatment might play a role in chemoprevention. Radiotherapy is also associated with a decreased incidence of PIN.

Key Words: prostate • prostatic intraepithelial neoplasia • intraductal dysplasia • intraductal carcinoma • atypical adenomatous hyperplasia • prostatic adenocarcinoma • chemoprevention

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