Distribution and significance of microcalcifications in the neoplastic and nonneoplastic prostate.

OBJECTIVE

To determine the distribution and significance of microcalcifications in histologic sections of the prostate.

DESIGN

Retrospective review of all histologic slides of completely embedded prostates from surgical specimens.

MATERIALS

Randomly selected material included 266 radical prostatectomy and 10 cystoprostatectomy prostates without prostate cancer. Nonrandomly selected specimens included 26 radical prostatectomy specimens with a Gleason pattern 5 component, 24 cases with collagenous micronodules, and 8 cases previously noted to have microcalcifications within foci of prostate cancer.

RESULTS

Four patterns of microcalcifications were noted in association with prostate cancer: (1) dystrophic calcification in the comedo-type necrosis of Gleason pattern 5, (2) intraluminal calcification in cribriform-type Gleason pattern 3 prostate cancer, (3) intraluminal calcification in small acinar adenocarcinoma, and (4) stromal calcification within collagenous micronodules associated with prostate cancer. Microcalcifications were noted in 32% of prostates without cancer; 1.9% of randomly selected prostates demonstrated microcalcifications associated with prostate cancer.

CONCLUSIONS

Microcalcifications are less common in association with prostate cancer than with benign prostatic ducts and acini. However, intraluminal microcalcifications associated with an atypical small glandular proliferation should not be taken as unequivocal evidence of a benign process.