ORIGINAL ARTICLES

Periacinar retraction clefting in proliferative prostatic atrophy and prostatic adenocarcinoma

Monika Ulamec¹, Davor Tomas¹, Christian Ensinger², Hrvoje upi¹, Mladen Belicza¹, Gregor Mikuz² and Boo Krulin¹

¹ Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital, Zagreb, Croatia
² Institute of Pathology, Medical University Innsbruck, Innsbruck, Austria

Correspondence to:
Professor Boo Krulin, Ljudevit Jurak Department of Pathology, Sestre milosrdnice University Hospital, Vinogradska cesta 29, 10 000 Zagreb, Croatia; bkruslin{at}kbsm.hr

Aims: To evaluate the presence and extent of periacinar retraction clefting in proliferative prostatic atrophy and carcinoma in radical prostatectomy specimens.

Methods: Atrophic foci and neoplastic glands were analysed in specimens from 50 patients who underwent radical prostatectomy. Analysed atrophic glands were classified in two main groups, proliferative atrophy (PA) and proliferative inflammatory atrophy (PIA); each group was subclassified into simple atrophy (SA) and postatrophic hyperplasia (PAH). According to the presence and extent of periacinar retraction clefting, atrophic and neoplastic glands were classified as: group 1, glands without clefts or with clefts affecting 50% of gland circumference; group 2, glands with clefts that affected >50% of the circumference in <50% of examined glands; and group 3, glands with clefts that affected >50% of the circumference in 50% of examined glands.

Results: Forty-four (88.0%) atrophic foci were without periacinar clefts or clefts were present in less than half of the gland circumference (group 1). In 6 (12.0%), atrophic foci clefts affected >50% of gland circumference (groups 2 and 3). Forty-five (90.0%) carcinomas were with clefts which affected more than 50% of gland circumference (groups 2 and 3); and in five carcinomas only, clefts were not found or affected <50% of gland circumference (group 1).

Conclusion: Results indicate that periacinar retraction clefting represents a reliable criterion in differential diagnosis between proliferative atrophy and carcinoma.

Abbreviations: PA, proliferative atrophy; PAH, postatrophic hyperplasia; PIA, proliferative inflammatory atrophy; SA, simple atrophy

Keywords: prostatic adenocarcinoma; prostatic atrophy; retraction clefting

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