Inflammatory Atrophy On Prostate Needle Biopsies: Is There Topographic Relationship To Cancer?

Introduction: Chronic inflammation of longstanding duration has been linked to the development of carcinoma in several organ systems. It is controversial whether there is any relationship of inflammatory atrophy to prostate cancer. It has been suggested that the proliferative epithelium in inflammatory atrophy may progress to high-grade prostatic intraepithelial neoplasia and/or adenocarcinoma. The objective of our study is to compare on needle prostate biopsies of patients showing cancer the topographical relation of inflammatory atrophy and atrophy with no inflammation to adenocarcinoma. Materials and Methods: The frequency and extent of the lesions were studied on 172 needle biopsies of patients with prostate cancer. In cores showing both lesions, the foci of atrophy were counted. Clinicopathological features were compared according to presence or absence of inflammation. Results: Considering only cores showing adenocarcinoma, atrophy was seen in 116/172 (67.44%) biopsies; 70/116 (60.34%) biopsies showed atrophy and no inflammation and 46/116 (39.66%) biopsies showed inflammatory atrophy. From a total of 481 cores in 72 biopsies with inflammatory atrophy 184/481 (38.25%) cores showed no atrophy; 166/481 (34.51%) cores showed atrophy and no inflammation; 111/481 (23.08%) cores showed both lesions; and 20/481 (4.16%) showed only inflammatory atrophy. There was no statistically significant difference for the clinicopathological features studied. Conclusion: The result of our study seems not to favor the model of prostatic carcinogenesis in which there is a topographical relation of inflammatory atrophy to adenocarcinoma.333355363Ames, B.N., Mutagenesis and carcinogenesis: Endogenous and exogenous factors (1989) Environ Mol Mutagen, 14, pp. 66-77Weitzman, S.A., Gordon, L.I., Inflammation and cancer: Role of phagocyte-generated oxidants in carcinogenesis (1990) Blood, 76, pp. 655-663Bartsch, H., Frank, N., Blocking the endogenous formation of N-nitroso compounds and related carcinogens (1996) IARC Sci Publ, 139, pp. 189-201Billis, A., Prostatic atrophy: An autopsy study of a histologic mimic of adenocarcinoma (1998) Mod Pathol, 11, pp. 47-54De Marzo, A.M., Marchi, V.L., Epstein, J.I., Nelson, W.G., Proliferative inflammatory atrophy of the prostate: Implications for prostatic carcinogenesis (1985) Am J Pathol, 999, p. 155Anton, R.C., Kattan, M.W., Chakraborty, S., Wheeler, T.M., Postatrophic hyperplasia of the prostate: Lack of association with prostate cancer (1999) Am J Surg Pathol, 23, pp. 932-936Putzi, M.J., De Marzo, A.M., Morphologic transitions between proliferative inflammatory atrophy and high-grade prostatic intraepithelial neoplasia (2000) Urology, 56, pp. 828-832Bakshi, N.A., Pandya, S., Schervish, E.W., Wojno, K.J., Morphologic features and clinical significance of post-atrophic hyperplasia in biopsy specimens of prostate (2002) Mod Pathol, 15, pp. 154ABillis, A., Magna, L.A., Inflammatory atrophy of the prostate. Prevalence and significance (2003) Arch Pathol Lab Med, 127, pp. 840-844Postma, R., Schroder, F.H., van der Kwast, T.H., Atrophy in prostate needle biopsy cores and its relationship to prostate cancer incidence in screened men (2005) Urology, 65, pp. 745-749Oppenheimer, J.R., Wills, M.L., Epstein, J.I., Partial atrophy in prostate needle cores: Another diagnostic pitfall for the surgical pathologist (1998) Am J Surg Pathol, 22, pp. 440-445Billis, A., Magna, L.A., Prostate elastosis: A microscopic feature useful for the diagnosis of postatrophic hyperplasia (2000) Arch Pathol Lab Med, 124, pp. 1306-1309Nickel, J.C., True, L.D., Krieger, J.N., Berger, R.E., Boag, A.H., Young, I.D., Consensus development of a histopathological classification system for chronic prostatic inflammation (2001) BJU Int, 87, pp. 797-805Srigley, J.R., Benign mimickers of prostatic adenocarcinoma (2004) Mod Pathol, 17, pp. 328-348Liavag, I., Atrophy and regeneration in the pathogenesis of prostatic carcinoma (1968) Acta Pathol Microbiol Scand, 73, pp. 338-350Cheville, J.C., Bostwick, D.G., Postatrophic hyperplasia of the prostate. A histologic mimic of prostatic adenocarcinoma (1995) Am J Surg Pathol, 19, pp. 1068-1076Rich, A.R., On the frequency of occurrence of occult carcinoma of the prostate (1935) J Urol, 33, p. 3Ro, J.Y., Sahin, A.A., Ayala, A.G., Tumors and tumorous conditions of the male genital tract (1995) Diagnostic Histopathology of Tumors, pp. 521-523. , Fletcher CDM eds, New York, Churchill LivingstoneMcNeal, J.E., Prostate (1997) Histology for Pathologists, pp. 997-1017. , Sternberg SS ed, second edition. Philadelphia, Lippincott-RavenBennett, B.D., Richardson, P.H., Gardner Jr., W.A., Histopathology and cytology of prostatitis (1993) Prostate Diseases, pp. 399-414. , Lepor H, Lawson RK eds, Philadelphia, WB Saunders CoBlumenfeld, W., Tucci, S., Narayan, P., Incidental lymphocytic prostatitis. Selective involvement with nonmalignant glands (1992) Am J Surg Pathol, 16, pp. 975-981Cohen, R.J., Shannon, B.A., McNeal, J.E., Shannon, T., Garrett, K.L., Propionibacterium acnes associated with inflammation in radical prostatectomy specimens: A possible link to cancer evolution? (2005) J Urol, 173, pp. 1969-197