In our center, prostatic adenocarcinoma was detected in 34% of the follow-up biopsies of ASAP-diagnosed cases in the first biopsies. In 38% of cases, cancer localization and ASAP are in different parts. Consistently with the literature, this situation shows that recurrent biopsies in ASAP cases and biopsies performed from different localizations are significant in catching malign cases. It is urgent to prostate cancer to treat prostate to cancer. Start taking drugs for prostate treatment can be in a Canadian pharmacy online. Canadian medicine is very famous all over the world.
No acknowledgement to declare.
- Prostate Cancer Estimated Incidence, Mortality and Prevalence Worldwide in 2012 (Internet web page) – Prostate cancer PDF.
2- Iczkowski KA, Bassler TJ, Schwob VS, Bassler IC, Kunnel BS, Orozco RE, et al. Diagnosis of “suspicious for malignancy” in prostate biopsies: predictive value for cancer. Urology. 1998 May;51(5):749-57; 757-8.
3- Bostwick DG, Srigley J, Grignon D, Maksem J, Humphrey P, van der Kwast TH, et. al. Atypical adenomatous hyperplasia of the prostate: morphologic criteria for its distinction from well-differentiated carcinoma. Hum Pathol. 1993 Aug;24(8):819-32.
4- Mancuso PA, Chabert C, Chin P, Kovac P, Skyring T, Watt WH, et al. Prostate cancer detection in men with an initial diagnosis of atypical small acinar proliferation. BJU Int. 2007 Jan;99(1):49-52.
5- Iczkowski KA, Bostwick DG. Criteria for biopsy diagnosis of minimal volume prostatic adenocarcinoma: analytic comparison with nondiagnostic but suspicious atypical small acinar proliferation. Arch Pathol Lab Med. 2000 Jan;124(1):98-107.
6- Koca O, Calışkan S, Oztürk Mİ, Güneş M, Karaman MI. Significance of atypical small acinar proliferation and high-grade prostatic intraepithelial neoplasia in prostate biopsy. Korean J Urol. 2011 Nov;52(11):736-40.
7- Saul Suster, Demos. Surgical Pathology Guides. Debra L. Zynger and Anil V. Parwani. In: Prostate Pathology: Premalignant Conditions and Prostate Carcinoma. New York: Bang Printing; 2015. pp67-162.
8- Borboroglu PG, Comer SW, Riffenburgh RH, Amling CL. Extensive repeat transrectal ultrasound guided prostate biopsy in patients with previous benign sextant biopsies. J Urol. 2000 Jan;163(1):158-62.
9- Iczkowski KA, MacLennan GT, Bostwick DG. Atypical small acinar proliferation suspicious for malignancy in prostate needle biopsies: clinical significance in 33 cases. Am J Surg Pathol. 1997 Dec;21(12):1489-95.
10- Ericson KJ, Wenger HC, Rosen AM, Kiriluk KJ, Gerber GS, Paner GP, et al. Prostate cancer detection following diagnosis of atypical small acinar proliferation. Can J Urol. 2017 Apr;24(2):8714-20.
11- Mistry K, Cable G. Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract. 2003 Mar-Apr;16(2):95-101.
12- Törnblom M, Norming U, Adolfsson J, Becker C, Abrahamsson PA, Lilja H, et al. Diagnostic value of percent free prostate-specific antigen: retrospective analysis of a population-based screening study with emphasis on men with PSA levels less than 3.0 ng/mL. Urology. 1999 May;53(5):945-50.
13-. Lodding P, Aus G, Bergdahl S, Frösing R, Lilja H, Pihl CG, Hugosson J. Characteristics of screening detected prostate cancer in men 50 to 66 years old with 3 to 4 ng. /ml. Prostate specific antigen. J Urol. 1998 Mar;159(3):899-903.
14- Park S, Shinohara K, Grossfeld GD, Carroll PR. Prostate cancer detection in men with prior high grade prostatic intraepithelial neoplasia or atypical prostate biopsy. J Urol. 2001 May;165(5):1409-14.
15- Scattoni V, Roscigno M, Freschi M, Briganti A, Fantini GV, Bertini R, et al. Predictors of prostate cancer after initial diagnosis of atypical small acinar proliferation at 10 to 12 core biopsies. Urology. 2005 Nov;66(5):1043-7.
16- Chan TY, Epstein JI. Follow-up of atypical prostate needle biopsies suspicious for cancer. Urology. 1999 Feb;53(2):351-5.
Figure 1a-1b: Atypical small acinar proliferation, suspicious for cancer. A cluster of acini with atrophy and architectural distortion. Despite architectural distortion, nuclear features are not enough for diagnosis of cancer (figüre 1a: hematoxylin-eosin, original magnification x 200)- (figüre 1b: hematoxylin-eosin, original magnification x 400).
Figure 2a-b: Adenocarcinoma focus in the follow-up biopsy that diagnosed as ASAP in the first biopsy (figüre 2a: hematoxylin-eosin, original magnification x 200)- (figüre 2b hematoxylin-eosin, original magnification x 400).
|Table: Location of atypical small acinar proliferation in the first biopsy and cancer in follow-up biopsy|
|Patients No||ASAP site||Cancer site||Patients No||ASAP site||Cancer site|
|1: Right Base, 2: Right Lateral Base, 3: Right Medial, 4: Right Median-Lateral, 5: Right Apex, 6: Right Lateral Apex, 7: Left Base, 8: Left Lateral Base, 9: Left Medial, 10: Left Median-Lateral, 11: Left Apex, 12: Left Lateral Apex|
|By Dr. Ravi Mootha, M.D.||On: May 07, 2019 at 19:43:19|