Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Histopathology. 2010 Apr;56(5):627-31. doi: 10.1111/j.1365-2559.2010.03525.x.
Sclerosing adenosis of the prostate is a benign, small, acinar proliferation in dense spindle cell stroma, with a distinct immunohistochemical profiles. It is incidentally found in about 2% of transurethral resection specimens. The aim was to describe cases with significant cytological atypia mimicking cancer, which have not been previously reported.
We describe five cases of sclerosing adenosis with significant cytological atypia, referred to as atypical sclerosing adenosis (ASA), which were initially considered suspicious or diagnostic of adenocarcinoma. Seven other cases of typical sclerosing adenosis were used as controls. All cases of typical and atypical sclerosing adenosis displayed an intact basal cell layer, which was immunoreactive for high-molecular-weight keratin, S100 protein, smooth muscle actin, and prostate-specific antigen, with no differences between ASA and the control group. Alpha-methylacyl-coenzyme A racemase was negative. Three of four cases of ASA had aneuploid DNA content by digital image analysis. All cases of typical sclerosing adenosis were diploid. During a mean follow-up of 33 months (range 5-73 months), none developed recurrence or prostatic cancer.
ASA is an unusual small, acinar proliferation of the prostate that may be mistaken for adenocarcinoma, and should be distinguished from other mimics, including atypical adenomatous hyperplasia, mesonephric remnant hyperplasia, and post-atrophic hyperplasia. ASA is a benign lesion and aggressive treatment is unwarranted.
前列腺硬化性腺病是一种良性、小的、腺泡性增生，位于致密的梭形细胞基质中，具有独特的免疫组织化学特征。它在大约 2%的经尿道前列腺切除术标本中偶然发现。目的是描述具有模仿癌症的显著细胞学异型性的病例，这些病例以前没有报道过。
我们描述了 5 例具有显著细胞学异型性的硬化性腺病，称为非典型硬化性腺病（ASA），最初被认为是可疑或诊断为腺癌。另外 7 例典型硬化性腺病作为对照。所有典型和非典型硬化性腺病的病例均显示完整的基底细胞层，对高分子量角蛋白、S100 蛋白、平滑肌肌动蛋白和前列腺特异性抗原呈免疫反应性，ASA 与对照组之间无差异。α-甲基酰基辅酶 A 消旋酶为阴性。4 例 ASA 中有 3 例通过数字图像分析显示异倍体 DNA 含量。所有典型硬化性腺病均为二倍体。在平均 33 个月（5-73 个月）的随访中，均未复发或发生前列腺癌。
ASA 是一种罕见的小的、前列腺的腺泡性增生，可能被误诊为腺癌，应与其他类似物区分开来，包括非典型腺瘤性增生、中肾残留增生和萎缩后增生。ASA 是一种良性病变，不需要积极治疗。
