High Grade Prostatic Intraepithelial Neoplasia (HGPIN)

High Grade Prostatic Intraepithelial Neoplasia (HGPIN):Common questions asked about HGPIN are :-How do we as pathologists make these diagnoses?-What do they mean for the patient in terms of cancer risk?-What is/are the optimal strategies for follow-up so that if cancer does eventually develop it is caught at an early, curable stage?Pathology criteria for diagnosis of HGPIN:-Architecturally benign acini/ducts lined by atypical cells.-These cells show large nuclei and prominent nucleoli (cytologic features of carcinoma).-Generally at least 10% of the luminal cells should show these features to make the diagnosis. Diagnosis of HGPIN has been shown to be reproducible. Low grade prostatic intraepithelial neoplasia has poor reproducibility (even among experts), ill defined diagnostic criteria, and no true clinical relevance. It is for these reasons that I do not personally diagnose LGPIN.Risk of subsequent cancer:-In previous studies the risk of carcinoma on follow-up biopsy for a HGPIN diagnosis has been reported to be as high as 50%, however, when the data is based on series with increased case numbers, this decrease to around 25%.-Number of cores with high grade PIN predicts risk of subsequent cancer (1 core-30%, 3 cores-40%, 4+ cores-75%).In addition, morphologic patterns of HGPIN (i.e. flat, tufted, micropapillary, cribriform) have not been shown to be predictive of subsequent carcinoma.Follow up strategy for patients with HGPIN:Although there have been several follow-up strat...
Source: Oncopathology - Category: Cancer & Oncology Tags: High Grade Prostatic Intraepithelial Neoplasia (HGPIN) Source Type: blogs