Publication Date:
2014-01-29
Description:
Aims Ductal adenocarcinoma of the prostate (DAC) is clinically important as its behaviour may differ from that of acinar adenocarcinoma. Our aim was to investigate the interobserver variability of this diagnosis among experts in uropathology and define diagnostic criteria. Methods and results Photomicrographs of 21 carcinomas with ductal features were distributed among 20 genitourinary pathologists from 8 countries. DAC was diagnosed by 18 observers (mean 13.2 cases, range 6-19). In 11 (52%) cases a 2/3 consensus was reached for a diagnosis of DAC and in 5 (24%) there was consensus against. In DAC the respondents reported papillary architecture (86%), stratification of nuclei (82%), high-grade nuclear features (54%), tall columnar epithelium (53%), elongated nuclei (52%), cribriform architecture (40%) and necrosis (7%). The most important diagnostic feature reported for DAC was papillary architecture (59%), while nuclear and cellular features were considered most important in only 2% to 11% of cases. The most common differential diagnoses were intraductal prostate cancer (52%), high-grade PIN (37%) and acinar adenocarcinoma (17%). The most common reason for not diagnosing DAC was lack of typical architecture (33%). Conclusions Papillary architecture was the most useful diagnostic feature of DAC, while nuclear and cellular features were considered less important. This article is protected by copyright. All rights reserved.
Print ISSN:
0309-0167
Electronic ISSN:
1365-2559
Topics:
Medicine
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