Frequência de critérios diagnósticos de adenocarcinoma acinar da próstata em biópsias de agulha com diagnóstico de próstata benigna, lesões atípicas e adenocarcinoma acinar

Abstract

FREQUENCY OF DIAGNOSTIC CRITERIA OF THE PROSTATE ADENOCARCINOMA ACINAR BIOPSIES NEEDLE WITH DIAGNOSIS OF BENIGN PROSTATE, INJURIES AND ADENOCARCINOMA ATYPICAL ACINAR.The diagnosis of acinar adenocarcinoma of the prostate has been made increasingly early and is based primarily on morphological criteria. Objective: To evaluate the sensitivity and specificity of morphologic criteria for acinar adenocarcinoma. Methods: It was analyzed 387 consecutive cases of prostatic needle biopsies. Cases were stratified according to the initial diagnosis (stained with hematoxylin and eosin). Results: The frequency of prominent nucleoli centralized in malignant, benign and suspicious cases were 99%, 89% and 27%, respectively. Marginal nucleoli (85%, 60% and 7%), double nucleoli (86%, 53% and 10%), multiple nucleoli (47%, 14% and 2%), eosinophilic intraluminal secretion (60%, 36% and 18 %), basophilic secretion (17%, 4% and 1%), crystalloids (42%, 24% and 3%), collagenous micronodules (6%, 0 and 0), glomerulations (11%, 0 and 0), mitoses (18%, 5% and 2%), perineural invasion (17%, 0 and 0), angiolymphatic (1%, 0, and 0) and extraprostatic extension (1%, 0, and 0) were all much less common in cases benign and showed statistically significant differences among groups. Discussion: After analysis of 36 cases initially diagnosed as suspected, marginalized nucleoli (62%, 50% and 45%) and mitosis (9% 0 and 0) were more closely associated with a final diagnosis of malignancy after immunohistochemistry. Centralized prominent nucleoli were more common in cases concluded as benign (85%, 50% and 100%). Conclusions: The location and the number of nucleoli are useful to identify suspicious lesions. Prominent nucleoli commonly directs to an initial diagnosis of suspicious lesions while immunohistochemistry will confirm the benign nature of many lesions.