Skip Navigation LinksHome > May/June 2014 - Volume 19 - Issue 3 > Atypical Small Acinar Proliferation of the Prostate: 16 Yea...
Pathology Case Reviews:
doi: 10.1097/PCR.0000000000000035
Reviews

Atypical Small Acinar Proliferation of the Prostate: 16 Years’ Experience

Iczkowski, Kenneth A. MD*; Bostwick, David G. MD, MBA

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Abstract

Abstract: We first described atypical small acinar proliferation suggestive of, but not diagnostic of, adenocarcinoma (ASAP) of the prostate in 1997. Atypical small acinar proliferation suggestive of, but not diagnostic of, adenocarcinoma represents our inability to render an incontrovertible diagnosis of cancer in about 2% to 5% of sets of needle biopsies and has a 40% to 50% predictive value for a definite cancer diagnosis on repeat biopsy. In this review, we discuss the justifications for reaching a diagnosis of ASAP, the clinical significance of ASAP, the differential diagnosis of a minimal focus on cancer versus ASAP, ASAP occurring in conjunction with high-grade prostatic intraepithelial neoplasia, and the use of immunostains using triple cocktail cytokeratin 34βE12/p63/p504S which can resolve some—but not all—cases of ASAP.

© 2014 by Lippincott Williams & Wilkins.

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