Prostatic intraepithelial neoplasia (PIN), particularly high-grade PIN (HGPIN), and atypical small acinar proliferation (ASAP) have been identified as precursor lesions to prostatic carcinoma. PIN refers to the precancerous end of a morphologic spectrum involving cellular proliferation within prostatic ducts, ductules, and acini. Bostwick and Brawer introduced the term PIN in 1987.1 At an international conference in 1989, the term PIN was accepted as a replacement for various other terms (eg, intraductal hyperplasia, hyperplasia with malignant change, large acinar atypical hyperplasia, marked atypia, ductal-acinar dysplasia.)
Three grades of PIN were initially described; however, those at the consensus conference agreed that only the terms low-grade PIN (LGPIN) and high-grade PIN (HGPIN) would be used. Many pathologists no longer report the presence of LGPIN and note only the histologic findings associated with HGPIN.
High-grade prostatic intraepithelial neoplasia
HGPIN is characterized by architecturally benign prostatic acini and ducts lined by atypical cells whose morphologic, histochemical, immunohistochemical, and genetic changes are similar to those of prostate cancer. HGPIN does not invade the basement membrane of the prostatic glands. LGPIN may also be a precursor lesion but is no longer considered to be important enough to be included in the pathologic description.
When HGPIN is identified, the pathologist carefully searches tissue specimens for evidence of cancer. Patients in whom HGPIN is found are usually advised by a urologist to begin continued follow-up care with serum prostate-specific antigen (PSA) testing, physical examination, and, possibly, repeat biopsies. An estimated 30% of men with HGPIN develop clinical evidence of prostate cancer within one year.
HGPIN itself is not considered to be a disease that produces symptoms, nor does it require therapy. Although the general agreement is that HGPIN is a potential harbinger for the development of clinical prostatic adenocarcinoma, most experts agree that observation alone is safe for these patients.
Tuesday, February 03, 2009
Health Update: Good News, Bad News
The biopsy came back showing no cancer, but it did show a "pre-malignant" lesion which may or may not lead to malignancy, and which requires that we do a second biopsy, in a few weeks time. The biopsy is somewhat painful. Twelve core tissue samples are taken. My prostate has to heal before it undergoes this again.
Wickipidia has a good, informative article that comes up under the word search, "Prostatic intraepithelial neoplasia."
This is what WebMD says: