Aspiration Biopsy of the Prostate Gland: A Brief Review of Collection, Fixation, and Pattern Recognition With Special Attention to Benign and Malignant Prostatic Epithelium

Abstract

The preparation and use of an alternate collection device for aspiration biopsy of the prostate is presented. The device is inexpensive and can be constructed from readily available office materials. Its use in conjunction with a liquid-phase collection of cellular products of aspiration biopsy by a backwash technique is described. Following this, a brief discussion of pattern recognition in cytological preparations of benign and malignant prostate epithelial aggregates is presented and illustrated.

Does imprint cytology improve the accuracy of transrectal prostate needle biopsy?

“…False imprint cytology results may occur if the biopsy technique or handling of the specimen is faulty . Furthermore, imprint cytology may give a false‐negative result in cases of well‐differentiated adenocarcinoma (because no obvious cytological criteria of malignancy may be apparent) and in samples in which the malignant cells lie below the surface . False‐negative rates of FNAB cytology range from 5 to 30% and from 1 to 10% of biopsy specimens .…”

“…The nucleoli of benign epithelial cells are generally indistinct (Fig. a,b) . Imprint preparations tend to contain much larger and cohesive groups revealing more architectural detail of tumors when present.…”

“…In some cases, anisopoikilonucleosis may predominate as the primary nuclear feature rather than nucleolar prominence (Fig. a,b) . Therefore, loss of nuclear polarity at the edge of cohesive clusters with a small acinar arrangement is also considered a sign of malignancy .…”

“…That is, while well‐differentiated tumors may resemble benign prostatic glandular tissue, decreasing differentiation in tumors is usually accompanied by increasing nuclear and cellular atypia, and irregular arrangement and dissociation of the cells (Fig. ) …”

“…1a,b). 12,13 Imprint preparations tend to contain much larger and cohesive groups revealing more architectural detail of tumors when present. Characteristics of malignancy are loss of intercellular cohesion, nucleolar prominence, and variation in nuclear size (anisonucleosis) and shape (poikilonucleosis).…”