Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the pros...
Summary Various findings in prostate tissue indicate raised risk of later prostate cancer, and, of all these, the finding ...
Figure 1  Morphological spectrum for normal prostate to high-grade prostatic intraepithelial neoplasia Montironi R  et al ...
Figure 2  High-grade prostatic intraepithelial neoplasia with neuroendocrine differentiation Montironi R  et al . (2007)  ...
Figure 3  Atypical basal-cell hyperplasia (adenosis) Montironi R  et al . (2007)  Mechanisms of Disease: high-grade prosta...
Figure 4  Adenocarcinoma originating from high-grade prostatic intraepithelial neoplasia Montironi R  et al . (2007)  Mech...
Figure 5  The effect of androgen ablation on high-grade prostatic intraepithelial neoplasia Montironi R  et al . (2007)  M...
Figure 6  Focal atrophy with high-grade prostatic intraepithelial neoplasia and adenocarcinoma Montironi R  et al . (2007)...
Table 1  Risk of detection of carcinoma on needle core repeat biopsy Montironi R  et al . (2007)  Mechanisms of Disease: h...
Key Points <ul><li>An enormous amount of knowledge, which indicates that high-grade prostatic intraepithelial neoplasia (H...
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Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate

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Various findings in prostate tissue indicate raised risk of later prostate cancer, and, of all these, the finding of high-grade prostatic intraepithelial neoplasia on repeated biopsy is most strongly associated. This Review discusses the morphologic spectrum and clinical importance of these proposed preneoplastic lesions and conditions of the prostate, especially high-grade prostatic intraepithelial neoplasia.

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Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate

  1. 1. Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Rodolfo Montironi, Roberta Mazzucchelli, Antonio Lopez-Beltran, Liang Cheng and Marina Scarpelli Nature Clinical Practice Urology (2007) 4 , 321-332 doi:10.1038/ncpuro0815 Nature Clinical Practice Urology (2007) 4 , 321-332 doi:10.1038/ncpuro0815 Nature Clinical Practice Urology (2007) 4 , 321-332 doi:10.1038/ncpuro0815
  2. 2. Summary Various findings in prostate tissue indicate raised risk of later prostate cancer, and, of all these, the finding of high-grade prostatic intraepithelial neoplasia on repeated biopsy is most strongly associated. This Review discusses the morphologic spectrum and clinical importance of these proposed preneoplastic lesions and conditions of the prostate, especially high-grade prostatic intraepithelial neoplasia.
  3. 3. Figure 1 Morphological spectrum for normal prostate to high-grade prostatic intraepithelial neoplasia Montironi R et al . (2007) Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Nat Clin Pract Urol 4: 321 – 332 doi:10.1038/ ncpuro0815
  4. 4. Figure 2 High-grade prostatic intraepithelial neoplasia with neuroendocrine differentiation Montironi R et al . (2007) Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Nat Clin Pract Urol 4: 321 – 332 doi:10.1038/ ncpuro0815
  5. 5. Figure 3 Atypical basal-cell hyperplasia (adenosis) Montironi R et al . (2007) Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Nat Clin Pract Urol 4: 321 – 332 doi:10.1038/ ncpuro0815
  6. 6. Figure 4 Adenocarcinoma originating from high-grade prostatic intraepithelial neoplasia Montironi R et al . (2007) Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Nat Clin Pract Urol 4: 321 – 332 doi:10.1038/ ncpuro0815
  7. 7. Figure 5 The effect of androgen ablation on high-grade prostatic intraepithelial neoplasia Montironi R et al . (2007) Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Nat Clin Pract Urol 4: 321 – 332 doi:10.1038/ ncpuro0815
  8. 8. Figure 6 Focal atrophy with high-grade prostatic intraepithelial neoplasia and adenocarcinoma Montironi R et al . (2007) Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Nat Clin Pract Urol 4: 321 – 332 doi:10.1038/ ncpuro0815
  9. 9. Table 1 Risk of detection of carcinoma on needle core repeat biopsy Montironi R et al . (2007) Mechanisms of Disease: high-grade prostatic intraepithelial neoplasia and other proposed preneoplastic lesions in the prostate Nat Clin Pract Urol 4: 321 – 332 doi:10.1038/ ncpuro0815
  10. 10. Key Points <ul><li>An enormous amount of knowledge, which indicates that high-grade prostatic intraepithelial neoplasia (HGPIN) might represent a heterogeneous group of lesions, has been gathered in a variety of intraductal and intra-acinar proliferations </li></ul><ul><li>Evidence indicating that HGPIN is related more closely to prostate cancer than to benign epithelium has been obtained from morphological, immunohistochemical, morphometric, molecular and genetic studies </li></ul><ul><li>The predictive value for cancer after an initial diagnosis of HGPIN on needle biopsy has substantially declined, mainly because of the increased use of needle biopsy core sampling </li></ul><ul><li>Findings other than HGPIN in the prostate might indicate premalignant disease, but the data for these are much less convincing than those for HGPIN </li></ul>

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