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Prostate gland & seminal vesicles

Acinar / ductal adenocarcinomas

Acinar adenocarcinoma

Pseudohyperplastic pattern

Author: Komal Arora, M.D.

Last author update: 1 March 2012

Last staff update: 21 November 2023

Copyright: 2003-2024, PathologyOutlines.com, Inc.

PubMed search: prostatic pseudohyperplastic adenocarcinoma

Table of Contents

Cite this page: Arora K. Pseudohyperplastic pattern. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/prostatepseudoCA.html. Accessed December 23rd, 2024.

Definition / general

Rare carcinoma that resembles benign hyperplastic glands
Difficult to grade
Epstein recommends deferring to the grade of the associated usual type adenocarcinoma in the radical prostatectomy specimen, which is often Gleason score 5-7
False negative diagnostic rate was 1.3% for TURP specimens (Pseudo Oncol Res 2003;9:232)
60% of tumor has benign architectural but malignant nuclear features (Am J Surg Pathol 2000;24:1039)

Case reports

70 year old man ( Case #117)

Microscopic (histologic) description

Papillary infoldings (100%), crowded glands, large atypical glands (95%), nuclear enlargement (95%), pink amorphous secretions (70%), occasional to frequent nucleoli (45%), branching (45%), crystalloids (45%), corpora amylacea (20%); at low power, transition to typical, small acinar adenocarcinoma may be helpful (Am J Surg Pathol 1998;22:1239)
With core needle biopsy, only diagnostic clue may be a subtle disruption of the normal glandular - stromal relationship (Mod Pathol 2004;17:307, Am J Surg Pathol 2010;34:35)
Despite its benign appearance, may be associated with intermediate grade cancer and can exhibit aggressive behavior

Microscopic (histologic) images

Case #117