Embryonal hyperplasia of the prostate

Abstract

Unusual patterns of prostatic hyperplasia require close scrutiny by the pathologist in order to distinguish them from adenocarcinoma. One such pattern, basal cell hyperplasia, has been the subject of several recent reports. We describe a second pattern, which we refer to as embryonal hyperplasia because of its resemblance to the embryonal or fetal prostate. Although this lesion bears some resemblance to basal cell hyperplasia, it differs in histochemical characteristics. A review of previous cases of this entity, which were reported as basal cell hyperplasia, suggests that they differ in ultrastructural characteristics as well. The significance of this proliferative pattern currently rests in its resemblance to prostatic adenocarcinoma, particularly when present in many chips from a transurethral resection of the prostate. Further studies, especially relating to hormone dependency, would be useful in understanding the development of this and other more atypical prostatic proliferations.

Basal Cell Hyperplasia in the Peripheral Zone of the Prostate

“…Cases were assessed for mitotic figures, intraluminal wispy blue mucin, necrotic intraluminal debris, individual cell necrosis, clear cell features, and associated inflammation; high-grade prostatic intraepithelial neoplasia; and adenocarcinoma. We analyzed the association of basal cell hyperplasia with high-grade prostatic intraepithelial neoplasia and carcinoma by 2 , with a P value of Ͻ.05 considered significant. Peripheral zone and transition zone basal cell proliferations were also evaluated in 26 consecutive, completely embedded prostate glands from radical prostatectomies performed in 1996 at Barnes-Jewish Hospital, as treatment for biopsyproven, clinically localized prostate carcinoma.…”

“…Basal cell hyperplasia is occasionally a component of untreated usual, nodular, glandular and stromal hyperplasia, or benign prostatic hyperplasia, which arises in the transition zone in the prostate (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Initially thought to be rare (1), the incidence of basal cell hyperplasia in the setting of usual, nodular hyperplasia has been reported to range from 3.1 to 8.9% (2,5,10,13,15).…”

“…Initially thought to be rare (1), the incidence of basal cell hyperplasia in the setting of usual, nodular hyperplasia has been reported to range from 3.1 to 8.9% (2,5,10,13,15). It has been noted that basal cell hyperplasia may be atrophy associated and found in the peripheral zone (11), but basal cell hyperplasia arising in the peripheral zone of the prostate has not been previously characterized.…”

A seemingly most effective target for early detection and intervention of prostate tumor invasion

“…These theories are consistent with experimental data from tissue cultures or animal models, but they are hard to reconcile with four critical facts: (a). previous studies have revealed that some healthy men between 19 and 29 years old demonstrated a spectrum of proliferative abnormalities in the prostate, including atypical hyperplasia, dysplasia, and incipient adenocarcinoma [11][12][13], (b) Recent studies have detected a DNA phenotype that is identical to the DNA structure of invasive prostate cancer in certain healthy men, and in normal prostate tissues adjacent to prostate cancer [14][15][16][17], (c) a majority of PIN express high le-vels of proteolytic enzymes, but only about 30% of untreated PIN progress to invasive lesions during patients' lifetime [18][19][20][21], and (d) results from worldwide human clinical trials with a wide variety of proteolytic enzyme specific inhibitors to treat or prevent tumor invasion have been very disappointing [22,23]. Together, these suggest that alternative mechanism(s) may exist for prostate tumor invasion.…”

Malignant Transformation and Stromal Invasion from Normal Appearing Prostate Tissues: True or False?

“…These theories are consistent with laboratory findings from cell cultures and animal models, whereas are hard to reconcile with a number of critical facts. First, previous studies revealed that some healthy men between 19 and 29 years old had a spectrum of proliferative lesions, including hyperplasia, PIN, and incipient adenocarcinoma [11][12][13]. Second, recent studies have detected a DNA phenotype identical to that of invasive prostate cancer in some "healthy" men, and also in normal prostate tissues adjacent to prostate cancer [14][15][16][17].…”