Functional Engagement of the PD-1/PD-L1 Complex But Not PD-L1 Expression Is Highly Predictive of Patient Response to Immunotherapy in Non-Small-Cell Lung Cancer.

PURPOSE: In many cancers, the expression of immunomodulatory ligands leads to immunoevasion, as exemplified by the interaction of PD-L1 with PD-1 on tumor-infiltrating lymphocytes. Profound advances in cancer treatments have come with the advent of immunotherapies directed at blocking these immuno-suppressive ligand-receptor interactions. However, although there has been success in the use of these immune checkpoint interventions, correct patient stratification for these therapies has been challenging. MATERIALS AND METHODS: To address this issue of patient stratification, we have quantified the intercellular PD-1/PD-L1 interaction in formalin-fixed paraffin-embedded tumor samples from patients with non-small cell lung carcinoma, using a high-throughput automated quantitative imaging platform (quantitative functional proteomics [QF-Pro]). RESULTS: The multisite blinded analysis across a cohort of 188 immune checkpoint inhibitor-treated patients demonstrated the intra- and intertumoral heterogeneity of PD-1/PD-L1 immune checkpoint engagement and notably showed no correlation between the extent of PD-1/PD-L1 interaction and PD-L1 expression. Importantly, PD-L1 expression scores used clinically to stratify patients correlated poorly with overall survival; by contrast, patients showing a high PD-1/PD-L1 interaction had significantly better responses to anti-PD-1/PD-L1 treatments, as evidenced by increased overall survival. This relationship was particularly strong in the setting of first-line treatments. CONCLUSION: The functional readout of PD-1/PD-L1 interaction as a predictive biomarker for the stratification of patients with non-small-cell lung carcinoma, combined with PD-L1 expression, should significantly improve the response rates to immunotherapy. This would both capture patients excluded from checkpoint immunotherapy (high PD-1/PD-L1 interaction but low PD-L1 expression, 24% of patients) and additionally avoid treating patients who despite their high PD-L1 expression do not respond and suffer from side effects.

Clinical impact of aspartyl aminopeptidase expression and activity in colorectal cancer.

Aspartyl aminopeptidase (ASP; EC 3.4.11.21) is a widely distributed and abundant cytosolic enzyme that regulates bioactive peptides such as angiotensin II. It has been demonstrated that the expression and activity of this enzyme is modified in tissue and serum of patients with several types of cancer. However, the involvement of ASP in the neoplastic development and survival of patients with colorectal cancer (CRC) has not been analyzed to date. The activity and messenger RNA expression of ASP in tumor tissue (n = 71) and plasma (n = 40) of patients with CRC was analyzed prospectively using fluorometric and quantitative real-time polymerase chain reaction methods. Data obtained from tumor tissue were compared with those from the surrounding normal mucosa. Classic pathologic parameters (grade, stage, nodal invasion, distant metastases and perineural, lymphatic, and vascular invasion) were stratified following ASP data and analyzed for 5-year survival. ASP was upregulated in CRC tissues, and greater activity correlated significantly with the absence of lymph node metastases and with better overall survival. Inversely, greater plasmatic ASP activity was associated with worse overall and disease-free survival. Data suggest that ASP is involved in colorectal neoplasia and point to this enzyme as a potential useful diagnostic tool in clinical practice.

Increased prolyl endopeptidase activity in human neoplasia.

Prolyl endopeptidase (EC 3.4.21.26) (PEP) is a serine peptidase that converts several biologically active peptides. This enzyme has been linked to several neurological, digestive, cardiovascular and infectous disorders. However, little is known about its involvement in neoplastic processes. This study analyzes fluorimetrically cytosolic and membrane-bound PEP activity in a large series (n=122) of normal and neoplastic tissues from the kidney, colon, oral cavity, larynx, thyroid gland and testis. Cytosolic PEP activity significantly increased in clear cell renal cell carcinoma, urothelial carcinoma of the renal pelvis and head and neck squamous cell carcinoma. Both cytosolic and membrane-bound PEP activity were also increased in colorectal adenomatous polyps. These data suggest the involvement of PEP in some mechanisms that underlie neoplastic processes.

Parámetros histológicos predictivos de la invasiónde las vesículas seminales en el cáncer de próstata / Predictive histological parameters of seminal vesicle invasion in prostate cancer

Antecedentes: La invasión de las vesículas seminales esun dato histológico de mal pronóstico en el cáncer de próstata.En la mayor parte de los casos es un hallazgo accidentalya que los pacientes con signos clínicos o histológicos deenfermedad extraprostática no se tratan mediante cirugía enla mayor parte de protocolos al uso. Nuestra intención escuantificar este hallazgo histológico en una serie homogéneade prostatectomías radicales y correlacionarlo con los hallazgosen las biopsias previas. Métodos: Durante un periodo de8 años (1998-2005), 363 pacientes con cáncer de próstatafueron tratados mediante prostatectomía radical en el Hospitalde Basurto. Los pacientes fueron seleccionados para lacirugía en función de la combinación de la estadificación clínica,niveles de PSA sérico y datos obtenidos de la biopsiaprevia. Los datos obtenidos en las prostatectomías se correlacionaron(rho de Spearman) con varios hallazgos histológicosprocedentes de las biopsias. Resultados: Se detectóinvasión seminal en 37 pacientes (10,2%). La invasiónmicroscópica de las vesículas seminales se correlacionó conlos milímetros totales de cáncer (media 20 mm, r=0,397),con el número de focos de tumor (media 3,8, r=0,383), conla invasión de ambos lados prostáticos (r=0,256), con elíndice de Gleason >7 (r=0,306), con la invasión perineural(r=0,318), y con el PIN de alto grado (r=0,142) en las biopsias,y con el índice de Gleason >7 (r=0,357), con el PIN dealto grado (r=0,211), con la extensión extraprostática(r=0,480), y con la invasión de márgenes quirúrgicos(r=0,287), invasión perineural (r=0,847), y afectación delápex (r=0,307), en las prostatectomías. Conclusiones: Lainvasión de las vesículas seminales es un hallazgo frecuenteen las piezas de prostatectomía radical, incluso después deuna selección correcta de pacientes para cirugía (..) (AU)

Background: Seminal vesicle invasion is a finding ofbad prognosis in prostate cancer. Its discovery in radicalprostatectomies is accidental in most cases becausepatients with clinical or histological evidence of extraprostaticdisease are not surgically treated in most clinical protocols.Our aim is to quantify this finding in a homogeneousseries of radical prostatectomies and to correlate itwith core biopsy findings. Methods: Over an 8-year period(1998-2005), a total of 363 patients with prostate cancerunderwent radical prostatectomy at Basurto Hospital. Thecombination of clinical staging, PSA levels and core biopsydata indicated the candidates for surgery. Data obtainedin prostatectomies were correlated (Spearman’s rho) withseveral histological parameters in biopsies. Results: Radicalprostatectomies showed seminal vesicle invasion in 37cases (10.2%). Microscopic seminal vesicle invasion correlatedwith total millimetres of cancer (average 20 mm,r=0.397), number of tumour foci (average 3.8, r=0.383),bilateral invasion (r=0.256), Gleason Index (GI) >7(r=0.306), perineurial invasion (r=0.318), and high gradePIN (HGPIN) (r=0.142) in biopsies, and with GI >7(r=0.357), HGPIN (r=0.211), extraprostatic extension(r=0.480), and margin (r=0.287), perineurial (r=0.847),and apex (r=0.307) invasions, in prostatectomies. Conclusions:Seminal invasion is a frequent finding in prostatectomies,even after a correct selection of patients for surgery.This finding correlates to tumour volume parameters,bilateral invasion, and other morphologic parameters ofbad prognosis in prostate cancer (AU)

Adenocarcinomas renales sincrónicos, de células claras y de células cromófobas / Synchronous renal adenocarcinomas, clear cell and chromophobe cell types

Caso clínico: Se presenta el caso de un paciente de 78años de edad al que se descubren dos neoplasias epitelialesindependientes y sincrónicas en el mismo riñón El tumordominante, el que llevó al paciente al médico y por el cualse realizó la nefrectomía corresponde a un carcinoma decélulas claras típico. El tumor secundario, localizado a 4cm. del tumor principal, fue detectado en el estudio macroscópicode la pieza quirúrgica y corresponde a un carcinomade células cromófobas. El patrón de inmunohistoquímica esel característico y esperado en cada tumor, y confirma laespecificidad de cada uno de ellos. Discusión: Se revisa yse discute la literatura actual relacionada con la coexistenciade diversos tumores de la misma o de distinta estirpe histológicaen el riñón (AU)

Case report: A case of double, independent and synchronousrenal epithelial neoplasms occurring in a 78 yearoldman is reported. The main tumour, the one that led thepatient to consult and the cause of nephrectomy, is a typicalclear cell renal cell carcinoma. The secondary tumour,located 4 cm from the main tumour, was discovered in grossexam and corresponded to a chromophobe cell renal cellcarcinoma. Immunohistochemistry is the expected in suchtumours. Discussión: We review and discuss current literaturerelated to the coexistence of various tumours of thesame or different histological type in the kidney (AU)

El adenocarcinoma de próstata en los años 1999 y 2006. Diferencias en el estudio comparativo de biopsias transrectales y de prostatectomías radicales / Prostate adenocarcinoma in 1999 and 2006. Differences in the comparative study of core biopsies and radical prostatectomies

Antecedentes: El incremento en el diagnóstico del cáncer de próstata en la última década en nuestros hospitales ha llevado consigo un aumento similar en el número de prostatectomías radicales. En este trabajo se analizan las diferencias histológicas observadas entre los pacientes tratados con cirugía radical en los años 1999 y 2006 y se evalúa la evolución habida en la indicación de cirugía radical en un lapso de 7 años. Métodos: Se analizan de forma comparativa los datos histológicos de las prostatectomías radicales, y de sus biopsias transrectales previas, diagnosticadas en 1999 y en 2006. Sólo se han incluido en el análisis los casos con la totalidad de los datos evaluables tanto en la biopsia como en la cirugía. En las biopsias transrectales se valoran la afectación uni o bilateral, el número de focos de tumor, los milímetros totales de tumor, la presencia de PIN de alto grado, el índice de Gleason, y la invasión perineural. En las prostatectomías radicales se evalúa el estadio (pT), el índice de Gleason, la presencia de PIN de alto grado, la invasión de los bordes, la afectación del ápex, la invasión perineural y vascular, la extensión extraprostática, y la invasión de las vesículas seminales. El estudio estadístico comparativo entre ambos grupos se realiza mediante pruebas de c2, t de Student, y Mann-Whitney. Resultados: El estudio incluye 24 prostatectomías radicales de 1999 y 50 de 2006. El pT es significativamente más bajo en 2006 que en 1999 (p=0,032). Asimismo, hay mayor número de carcinomas organo-confinados en 2006 (p=0,034). Además, la extensión extraprostática del cáncer y la invasión de vesículas seminales son significativamente menores en 2006 (p=0,090 y p=0,011, respectivamente). Conclusiones: En 2006, entre los pacientes que han sido tratados con cirugía radical, se observa una disminución significativa en el estadio tumoral. El número de casos con extensión extraprostática y con invasión de vesículas seminales es, asimismo, menor

Background: The increase in number of prostate cancer diagnoses in the last decade is accompanied by a similar increase in the number of radical prostatectomy specimens. We analyse the histological differences between patients treated with radical surgery in 1999 and in 2006. The evolution in the indications for surgery is also evaluated. Methods: Histological data in core biopsies and radical prostatectomies of cases diagnosed in 1999 and 2006 have been compared. Only cases with complete histological information have been included in the study. Bi/unilateral tumour invasion, number of tumour foci, total millimetres of cancer, high-grade PIN, Gleason index, and perineurial invasion have been evaluated in core biopsies. Pathological staging, Gleason index, high-grade PIN, margin status, apex invasion, perineurial and vascular permeation, extraprostatic extension and seminal vesicle invasion have been analysed in radical prostatectomies. The statistical study included c2, Student’s t, and Mann-Whitney test. Results: The study includes 24 radical prostatectomies in 1999 and 50 in 2006. The pathological staging is significantly lower in 2006 than in 1999 (p=0.032). Similarly, organ-confined disease is more frequent in 2006 (p=0.034). Extraprostatic extension and seminal vesicle invasion by prostate adenocarcinoma are significantly lower in 2006 (p=0.090 y p=0.011, respectively). Conclusions: Prostate adenocarcinoma patients treated with radical surgery in 2006 are at a lower stage compared with 1999 cases

Importancia clínica del diagnóstico de neoplasia intraepitelial prostática de alto grado y del de proliferación microglandular atípica en biopsias transrectales / Clinical relevance of a diagnosis of high grade prostatic intraepithelial neoplasia or atypical small acinar proliferation in transrectal core biopsies

Antecedentes: La neoplasia intraepitelial prostática de alto grado (PIN-AG) y el foco de microglándulas atípicas (ASAP) son dos hallazgos histológicos estrechamente relacionados con el cáncer de próstata. En este trabajo se analiza una serie amplia de ambos diagnósticos como único dato reseñable en la primera biopsia y su relación con el adenocarcinoma de próstata aparecido en biopsias subsiguientes. Métodos: Se analizan histológicamente 125 PIN-AG sin adenocarcinoma concomitante y 45 ASAP diagnosticados entre un total de 4.770 biopsias transrectales durante un periodo de 8 años (1998-2005). Se analizan todas las rebiopsias de cada uno de los casos y las características propias de los carcinomas aparecidos en algunas de éstas. Resultados: El porcentaje de cáncer en la muestra general es del 30,3%. Sin embargo, entre los casos previamente diagnosticados de PIN-AG se detectó cáncer en 21 (16,8%) y entre los diagnosticados de ASAP, en 12 (26,7%). La demora media entre ambos diagnósticos y el cáncer fue de 12,3 y 12,7 meses, respectivamente. El número de rebiopsias necesarias hasta la aparición de cáncer fue de 1 a 4 en el PIN-AG y de 1 a 3 en el ASAP. Se observa una correlación significativa entre el PIN-AG y varios parámetros histológicos del cáncer en la biopsia [número de focos de cáncer (p=0,003), milímetros totales de cáncer (p=0,000), bilateralidad (p=0,024), Índice de Gleason (p=0,011), invasión perineural (p=0,015)] y en la prostatectomía radical [pT (p=0,010)]. Conclusiones: No existe mayor probabilidad de detectar cáncer de próstata en aquellos pacientes con diagnóstico previo de PIN-AG o ASAP respecto de la población general que se biopsia. En el caso de existir cáncer, pueden ser necesarias hasta 4 biopsias repetidas para detectarlo

Background: High-grade PIN and ASAP are histological findings closely related to prostate cancer. We analyse a large series of both diagnoses and their relationship with the prostate cancers appeared in subsequent biopsies. Methods: We analyse 125 high-grade PIN and 45 ASAP cases diagnosed among 4,770 transrectal biopsies during an 8-year period (1998-2005). The histological characteristics of all the rebiopsies and the peculiarities of every cancer subsequently diagnosed of cancer are reviewed. Results: Prostate cancer was detected in 30.3% in the general series. However, it was found only in 16.8% and 26.7% of cases previously diagnosed as high grade PIN and ASAP, respectively. Mean delay in the diagnosis of cancer was 12.3 and 12.7 months and the number of rebiopsies needed for it oscillated between 1and 4 in high-grade PIN and 1 and 3 in ASAP. A significant correlation between high-grade PIN and several histological parameters of cancer in the biopsy [number of cancer foci (p=0.003), total millimetres of cancer (p=0.000), bilateralism (p=0.024), Gleason index (p=0.011), perineurial invasion (p=0.015)] and in the radical prostatectomy [pT (p=0.010)] were detected. Conclusions: There is no higher probability to found prostate cancer in cases with previous high-grade PIN or ASAP. The diagnosis of cancer may need up to 4 repeated biopsies

Basaloid squamous cell carcinoma of the head and neck: a clinicopathological and follow-up study of 40 cases and review of the literature.

Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of cancer that mainly arises in the upper aerodigestive tract. This study reviews the clinico-pathological features and follow-up of a series of cases occurring in the head and neck. During a 32-year period (1974-2005), a total of 40 BSCCs have been diagnosed in the head and neck in our Institution. Males predominated in the series (35M/5F). The average age was 60.2 years (range, 40-85). Tobacco and alcohol consumption was found in more than 80% of the cases. Topographic distribution was as follows: larynx and hypopharynx, 22 cases (55%); oropharynx, 12 cases (30%); and oral cavity 6 cases (15%). The basaloid component predominated in 29 cases (72.5%). Vasculo-lymphatic invasion was detected in 5 cases (12.5%). Lymph node metastases were seen in 25 cases (62.5%, levels II and III in the neck dissection). Local recurrences appeared in 11 cases (27.5%) and distant metastases in 6 (15%). In 7 cases (17.5%) a second primary tumour was detected. The 2002 TNM staging was as follows: Stage I, 5 cases (12.5%); Stage II, 7 cases (17.5%); Stage III, 8 cases (20%), and Stage IV, 20 cases (50%). On follow-up, 21 cases (52.5%) are alive and 19 (47.5%) died of disease. Three- and 5-year overall survival was 50% and 38.5%, respectively. A significant shorter survival was detected in node positive patients (P<0.05).

The quantification of the tumor volume in transrectal core biopsies of the prostate / The quantification of the tumor volume in transrectal core biopsies of the prostate

Está comúnmente aceptado en la literatura médica que la cantidad de tumor en la biopsia transrectal de próstata se correlaciona con el estadio tumoral y con otros parámetros de importancia pronóstica en el cáncer de próstata. En este trabajo se correlacionan los hallazgos histológicos con impacto pronóstico que se han observado en 363 prostatectomías radicales y en sus respectivas biopsias previas, tratando de evaluar qué sistema de medición del volumen tumoral (milímetros totales de cáncer, número de focos tumorales, y porcentaje de tumor en la biopsia) es el más apropiado en la práctica diaria. Los resultados demuestran que todos ellos se correlacionan con el estadio (pT), con el índice de Gleason, y con la invasión perineural. Además, hemos encontrado que más de 22 milímetros de cáncer en la biopsia predice extensión extraprostática en el 100% de los casos. En conclusión, aunque los 3 métodos pueden ser válidos, pensamos que la determinación de los milímetros totales de cáncer es el sistema de elección para cuantificar el volumen tumoral en las biopsias transrectales debido a su reproductibilidad y fiabilidad

It is widely accepted that the amount of tumour in core biopsies correlates with staging and other clinical parameters of prognostic significance in prostate cancer. A series of 363 radical prostatectomies and their respective previous core biopsies have been reviewed trying to correlate 3 different ways of measuring tumour volume (total millimetres of cancer, number of tumour foci, and percentage of tumour in the biopsy) with extraprostatic disease and other ominous parameters in surgical specimens. Results show that all the three systems correlate with pT category, Gleason index, and perineural invasion in radical specimens. In addition, we found that more than 22 millimetres of cancer in the biopsy predicts extraprostatic invasion in 100% of cases. We conclude that, although the three ways of evaluation the tumour volume work, total millimetres of cancer is the system of choice due to its feasibility and reliability

El adenocarcinoma diminuto en la biopsia transrectal de la próstata. Correlación con los hallazgos en la prostatectomía radical en 46 casos / Minute carcinoma on transrectal biopsy of the prostate. Correlation with radical prostatectomy findings in 46 cases

Antecedentes: El carcinoma diminuto es un hallazgo común el las biopsias transrectales de próstata. Su significado es equívoco para el urólogo debido a que su identificación no implica necesariamente que la enfermedad esté confinada en la próstata ni que su índice de Gleason sea bajo. Métodos: Durante un periodo de 8 años (1998-2005) se han realizado un total de 46 prostatectomías radicales en pacientes cuyas biopsias previas contenían un adenocarcinoma diminuto, definido éste como un solo foco de cáncer de 0,5 mm o menos en toda la biopsia. Esto supone un 12,67% de los casos en nuestro material. Este hallazgo ha sido evaluado histológicamente en las biopsias transrectales y correlacionado con datos relevantes en las correspondientes prostatectomías radicales (grado de extensión tumoral, índice de Gleason, PIN de alto grado, invasión perineural, extensión extraprostática, y estado de los márgenes quirúrgicos). Resultados: Los datos histológicos más frecuentes que caracterizan al carcinoma diminuto son: índice de Gleason ≤7 (43/46), agrandamiento nuclear (41/46), patrón infiltrante (41/46), presencia de nucleolo (41/46), PIN de alto grado (27/46), secreciones intraglandulares (26/46), y cristaloides (22/46). Se observó una correlación evidente con el grado de extensión tumoral y con el índice de Gleason. Los márgenes positivos y la invasión perineural y del ápex también fueron hallazgos frecuentes. Conclusiones: El carcinoma diminuto es un hallazgo frecuente en las biopsias transrectales de próstata y puede estar asociado a parámetros de mal pronóstico en las prostatectomías radicales

Background: Minute carcinoma is a common finding in prostate core biopsies. Its exact significance remains controversial to the urologists because it does not necessarily imply low Gleason Index or organ confined disease. Methods: Over an 8-year period (1998-2005), 46 radical prostatectomies with a diagnosis of minute carcinoma on previous core biopsies were identified. It represents 12.67% of cases in our material. Minute carcinoma was defined as one focus of cancer 0.5 mm in length or less in the biopsy material. This finding was morphologically characterized in core biopsies and its presence correlated with T category, Gleason index, status of the surgical margins at the apex, high grade PIN, perineurial invasion, and extraprostatic extension on radical prostatectomies. Results: Gleason index ≤7 (43/46), nuclear enlargement (41/46), infiltrative pattern (41/46), nucleoli (41/46), high grade PIN (27/46), intraglandular secretions (26/46), crystalloids (22/46), were the most consistent findings in core biopsies. Correlations of minute carcinoma with organ confined disease category and with Gleason index were evident. In addition, positive margins, and apex and perineurial invasions were variably found. Conclusions: Minute carcinoma is a common finding in core biopsies and may be associated to some parameters of bad prognosis in radical prostatectomies

Carcinoma basaloide escamoso del pene. Presentación de un caso / Basaloid squamous cell carcinoma of the penis. A case report

Introducción: Los tumores malignos epiteliales delpene son muy infrecuentes en los países desarrollados. Sehan descrito distintas variedades de carcinoma entre las cualesuna de las más infrecuentes y más agresivas es el carcinomabasaloide escamoso. Pacientes y métodos: Se presentaun caso de un carcinoma basoescamoso del pene en unpaciente de 75 años. Resultados: Se analizan los datos histológicosclaves en el diagnóstico de este tumor: nidostumorales constituidos por células de núcleo hipercromáticoy citoplasma escaso de hábito basal, con empalizadasperiféricas, centrados por elementos escamosos con queratinizaciónevidente. Discusión y conclusiones: Se revisa laescasa literatura existente sobre esta entidad en esta localizaciónhaciendo hincapié en su relación con la infección porvirus de papiloma humano (HPV) tipo 16

Introduction: Penis malignant epithelial tumors arevery infrequent in developed countries. Basaloid squamouscell carcinoma is one of the most infrequent and aggressivevarieties of penile carcinomas. Patients and methods: Acase of basaloid squamous cell carcinoma of the penis in a75 year old man is reported. Results: Main histological featuresof this rare and aggressive subtype of penile carcinomaare: tumor nests composed of basal-type cells withhyperchromatic nuclei and scanty cytoplasms presentingperipheral palisading centered by squamous cells with evidentkeratinization. Discussion and conclusions: Currentliterature is reviewed ad commented putting special emphasison the possible relationship with human papillomavirus(HPV) type 16 infection

Carcinoma renal de los túbulos colectores de bajo grado (carcinoma túbulo-quístico) / Low grade renal collecting duct carcinoma (renal tubulo-cystic carcinoma)

Introducción: Esta variedad de carcinoma renal esextraordinariamente infrecuente y está considerada comouna subvariante poco agresiva del carcinoma renal de lostúbulos colectores de Bellini. Pacientes y métodos: Se presentaun caso en un paciente varón de 73 años de edad quedebuta con hematuria y dolor en el hipocondrio derecho.Resultados: El diagnóstico fue de carcinoma renal de lostúbulos colectores de bajo grado. Discusión y conclusiones:Se analizan sus características histológicas e inmunohistoquímicas,y se revisan los casos previamente publicadosy las teorías vigentes sobre su histogénesis

Introduction: This is an exceptionally rare histologicalvariant of renal cell carcinoma considered the low gradecounterpart of Bellini’s duct carcinoma. Patients andmethods: The patient was a 73 year-old male that came tothe hospital because of hematuria and pain at the right abdominalflank. Results: Diagnosis of low grade renal collectingduct carcinoma was delivered. Discussion and conclusions:Histological and immunohistochemical characteristicsof this tumour are analysed in this report. Previousreported cases and histogenetic theories are also reviewed

Revisión de los adenocarcinomas de próstata con patrón pseudohiperplásico y pseudoatrófico / Pseudohyperplastic and pseudoatrophic patterns in prostate adenocarcinoma. A review

El adenocarcinoma de próstata es el cáncer más frecuentey la segunda causa de muerte por cáncer en la poblaciónmasculina en los países desarrollados. El volumen de biopsiasde próstata recibido en los laboratorios de AnatomíaPatológica de nuestros hospitales ha crecido espectacularmenteen la última década. El espectro morfológico de estaneoplasia es muy variado, en ocasiones difícil de reconocer,pudiendo simular lesiones benignas o estructuras histológicasnormales. Se revisan las características histológicas delos patrones pseudohiperplásico y pseudoatrófico del adenocarcinomade próstata, dos variedades que simulan los doshallazgos más frecuentes en patología prostática: la hiperplasiay la atrofia. El reconocimiento de estos patrones pocofrecuentes es especialmente importante en las biopsias transrectalespara facilitar el manejo correcto de los pacientes

Prostate adenocarcinoma is the leading neoplasm andthe second cause of death by cancer in males of developedcountries. Over the last decade, the number of prostate biopsieshas raised tremendously in the Pathology Labs of ourHospitals. The morphologic spectrum of this neoplasm isvaried, sometimes difficult to recognise, mimicking benignlesions or normal structures in the area. This paper reviewsthe histological features of the so-called pseudohyperplasticand pseudoatrophic patterns of prostate adenocarcinomas;the two subtypes of cancer that more closely mimic the twomore frequent benign lesions in the prostate. The recognitionof these histological variants in core biopsies is necessaryto favour the correct patient management