Do prostatic transition zone tumors have a distinct morphology? Journal Article

Authors: Garcia, J. J.; Al-Ahmadie, H. A.; Gopalan, A.; Tickoo, S. K.; Scardino, P. T.; Reuter, V. E.; Fine, S. W.
Article Title: Do prostatic transition zone tumors have a distinct morphology?
Abstract: Previous studies have proposed that the morphologic spectrum of prostatic glands of variable size with tall columnar cells displaying basally oriented nuclei and clear to pale pink cytoplasm (TZ-LOOK) is characteristic of the well to moderately differentiated component of transition zone (TZ) tumors. However, the specificity of these findings has not been well studied. In a recent report, we identified dominant peripheral zone (PZ) and TZ tumors situated anterior to the prostatic urethra. Currently, we evaluate the histopathologic features of 215 dominant tumors, including 63 TZ and 73 anterior PZ lesions and an additional cohort of 79 posterior PZ tumors, in radical prostatectomy specimens, to identify the prevalence of this morphology in tumors of different zonal origin. Each dominant tumor was assigned a TZ-LOOK extent score of 0 to 4, with 0=no such morphology, 1=1% to 25%, 2=26% to 50%, 3=51% to 75%, and 4=>75%. Overall, 121/215 (56%) tumors showed some degree of this histology, including 56 of 63 (89%) TZ tumors and 65 of 152 (43%) PZ tumors (P<0.0001). Thirty-seven of 215 (17%) lesions had scores of 3 to 4, with 31 (84%) of these being of TZ origin. However, only 31/63 (49%) TZ tumors had >50% TZ-LOOK. Among PZ tumors, 6/152 (4%) had predominant (>50%) TZ-LOOK morphology, yet 23/152 (15%) of all PZ tumors and 23/65 (35%) of PZ tumors displaying any degree of TZ-LOOK had scores of 2 to 3 (>25%; nonfocal). In tumors of both zones with predominant (scores 3 to 4; >50%) TZ-LOOK histology, darker glands of usual acinar adenocarcinoma was often seen at the periphery. Conversely, in tumors with nonpredominant TZ-LOOK (scores 1 to 2; ≤50%), these glands were frequently admixed with small glands bearing dark cytoplasm. In this series, we demonstrate that some degree of TZ-LOOK morphology is twice as frequent in dominant TZ tumors than in PZ tumors. Tumors demonstrating >50% of this histology are very likely of TZ origin, but this scenario occurs in only half of TZ tumors. Importantly, the TZ-LOOK is nonfocal in up to 35% of PZ tumors xhibiting any degree of this morphology. Given this lack of specificity, caution should be exercised in assigning zone of origin based on this histologic appearance, especially in limited samples such as prostate needle biopsy. © 2008 by Lippincott Williams & Wilkins.
Keywords: controlled study; human tissue; clinical feature; histopathology; adenocarcinoma; pathology; morphology; prostatic neoplasms; prostate; prostatectomy; prostate tumor; needle biopsy; cell membrane; scoring system; radical prostatectomy; prostate adenocarcinoma; acinar cell carcinoma; peripheral zone; transition zone
Journal Title: American Journal of Surgical Pathology
Volume: 32
Issue: 11
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2008-11-01
Start Page: 1709
End Page: 1714
Language: English
DOI: 10.1097/PAS.0b013e318172ee97
PUBMED: 18769336
PROVIDER: scopus
PMCID: PMC3010973
Notes: --- - "Cited By (since 1996): 6" - "Export Date: 17 November 2011" - "CODEN: AJSPD" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Peter T Scardino
    662 Scardino
  2. Satish K Tickoo
    453 Tickoo
  3. Joaquin Jesus Garcia
    11 Garcia
  4. Anuradha Gopalan
    375 Gopalan
  5. Samson W Fine
    420 Fine
  6. Victor Reuter
    1182 Reuter