Prostatic ductal adenocarcinoma presenting as a urethral polyp: A clinicopathological study of eight cases of a lesion with the potential to be misdiagnosed as a benign prostatic urethral polyp

Samaratunga H. and Letizia B. (2007) Prostatic ductal adenocarcinoma presenting as a urethral polyp: A clinicopathological study of eight cases of a lesion with the potential to be misdiagnosed as a benign prostatic urethral polyp. Pathology, 39 5: 476-481. doi:10.1080/00313020701570004


Author Samaratunga H.
Letizia B.
Title Prostatic ductal adenocarcinoma presenting as a urethral polyp: A clinicopathological study of eight cases of a lesion with the potential to be misdiagnosed as a benign prostatic urethral polyp
Journal name Pathology   Check publisher's open access policy
ISSN 0031-3025
Publication date 2007
Sub-type Article (original research)
DOI 10.1080/00313020701570004
Volume 39
Issue 5
Start page 476
End page 481
Total pages 6
Language eng
Subject 2734 Pathology and Forensic Medicine
Abstract Aims: Centrally located prostatic ductal adenocarcinoma can present as a single urethral polyp mimicking a benign polyp. Such lesions have not been formally studied. Methods and results: Clinicopathological and immunohistochemical findings of eight cases were analysed. Patients (mean age 76 years) presented with urinary symptoms and haematuria. Mean serum prostate specific antigen (PSA) was 7.01 ng/mL (range 1.04-21). Single small polyps were seen on cystourethroscopy with a clinical diagnosis of benign polyps. The most common architectural patterns were cribriform and papillary. Five cases had mild cytological atypia, three of which were initially diagnosed as benign prostatic urethral polyps. All cases were positive for PSA and 34βE12. Seven cases tested were positive for AMACR (a-methylacyl-CoA racemase), p63 and cytokeratin (CK) 7 and 70% for CK20. Proliferative activity defined as Ki-67 labelling index was high (mean 26%, range 20-35%). Adenocarcinoma, predominantly ductal, was found in other specimens in four patients. Conclusions: Centrally located prostatic ductal adenocarcinoma has the propensity to mimic benign urethral polyps clinically and histopathologically. Basal cell immunostaining may not help with this distinction but AMACR is useful. Prominent glandular complexity including cribriform patterns, nuclear pseudostratification, at least mild atypia and a high Ki-67 index distinguish these lesions from prostatic urethral polyps.
Keyword Prostatic ductal adenocarcinoma
Urethral polyps
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
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