Atypical small acinar proliferation

In urologic pathology, atypical small acinar proliferation, is a collection of small prostatic glands, on prostate biopsy, whose significance is uncertain and cannot be determined to be benign or malignant.

Atypical small acinar proliferation
Other namesASAP

ASAP, generally, is not considered a pre-malignancy, or a carcinoma in situ; it is an expression of diagnostic uncertainty,[1] and analogous to the diagnosis of ASCUS (atypical squamous cells of undetermined significance) on the Pap test.

Association with adenocarcinoma

On a subsequent biopsy, given the diagnosis of ASAP, the chance of finding prostate adenocarcinoma is approximately 40%; this is higher than if there is high-grade prostatic intraepithelial neoplasia (HGPIN).[2]

Management

ASAP is considered an indication for re-biopsy;[3] in one survey of urologists[4] 98% of respondents considered it a sufficient reason to re-biopsy.

See also

References
  1. Flury SC, Galgano MT, Mills SE, Smolkin ME, Theodorescu D (January 2007). "Atypical small acinar proliferation: biopsy artefact or distinct pathological entity". BJU International. 99 (4): 780–5. doi:10.1111/j.1464-410X.2006.06703.x. PMID 17378841. S2CID 30734977. Archived from the original on 2013-01-05.
  2. Leite KR, Camara-Lopes LH, Cury J, Dall'oglio MF, Sañudo A, Srougi M (June 2008). "Prostate cancer detection at rebiopsy after an initial benign diagnosis: results using sextant extended prostate biopsy". Clinics. 63 (3): 339–42. doi:10.1590/S1807-59322008000300009. PMC 2664245. PMID 18568243.
  3. Bostwick DG, Meiers I (July 2006). "Atypical small acinar proliferation in the prostate: clinical significance in 2006". Arch. Pathol. Lab. Med. 130 (7): 952–7. doi:10.5858/2006-130-952-ASAPIT. PMID 16831049.
  4. Rubin MA, Bismar TA, Curtis S, Montie JE (July 2004). "Prostate needle biopsy reporting: how are the surgical members of the Society of Urologic Oncology using pathology reports to guide treatment of prostate cancer patients?". Am. J. Surg. Pathol. 28 (7): 946–52. doi:10.1097/00000478-200407000-00016. PMID 15223967. S2CID 12886636.
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