Basal cell hyperplasia (BCH)‎ versus high grade prostatic intraepithelial neoplasia (HGPIN)‎ in tiny prostatic needle biopsies : unusual diagnostic dilemma

الملخص EN

Background : Histopathological differentiation between BCH and HGPIN in prostatic needle biopsies is a diagnostic challenge.

The gold standard for detection of HGPIN and BCH is histopathological examination ; however subjectivity in interpretation and tiny volume of obtained tissue hamper reliable diagnosis.

Aims : The aim of this study was to assess usefulness of using the p63 and p504s to solve this prob-lem.

Although the use of p63 and p504s is now well established in differentiation between preneo- plastic and neoplastic prostatic lesions, their usefulness in tiny tissue material is, however, not fully studied.

Methods : The study included a spectrum of 30 prostatic needle biopsies (5 BCH, 10 HGPIN, 10 indefinite luminal proliferations where BCH and HGPIN could not be distinguished from each other and 5 adenocarcinomas).

H&E stained sections were examined for histopathological features.

Other sections were stained immunohistochemically with p63 and p504s.

Results : The mean age of patients was 69 (SD = 7.6) years.

PSA range was 1.3–2.7 ng / ml.

Ultra-songraphic findings were unremarkable.

All BCH showed p504s / p63+ pattern, All HGPIN had p504s+ / p63+ pattern while carcinomas were p504s+ / p63.

After immunostaining combined with histopathological features; the 10 indefinite specimens could be diagnosed as 4 BCH and 6 HGPIN.

The article explains how applying this staining pattern on the challenging specimens, combined with histopathological features, can be helpful in proper identification of prostatic proliferations.