The differentiation of small foci of prostatic carcinoma seen in core biopsies from mimics may be problematic. The process of performing the biopsy may distort the tissue. Both carcinoma and its mimics may be composed of small glands.
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prostatic hypertrophy |
scattered glands may be negative |
positive in some cases |
positive |
|
|
atypical adenomatous hyperplasia |
variable proportion of glands may be negative |
positive in some cases |
positive |
|
|
flat high-grade PIN |
staining may be fragmentary |
positive in more than 50% of cases |
positive |
|
|
prostatic intraduct carcinoma |
basal cells may be present |
|
positive |
|
|
basal cell hyperplasia |
basal cells positive |
negative |
positive |
|
|
atypical basal cell hyperplasia |
basal cells positive |
negative |
positive |
|
|
seminal vesicles |
basal cells positive |
negative |
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|
ejaculatory duct epithelium |
basal cells positive |
negative |
negative |
|
|
nephrogenic adenoma |
may be completely negative for basal cell markers |
variable |
negative/ weakly positive |
|
|
benign mesonephric remnants |
may be completely negative for basal cell markers |
? |
negative |
|
|
Cowper's glands |
variable |
? |
variable |
|
|
Prostatic adenocarcinoma |
Positivity may be seen in high grade carcinomas, but is luminal. Positivity is rarely seen in gland-forming acinar carcinomas (Gleason grades 2 to 6). |
positive, except variants such as foamy cell, atrophic and pseudohyperplastic. |
positive |
|
Cystatin A and calcyclin have been proposed as basal cell markers but have not yet been validated by independent studies1.
References
1 Hammed O, Humphrey PA. Immunohistochemistry in the diagnosis of minimal prostate cancer. Current Diagnostic Pathology 2006;12:279-291.