Histopathological spectrum of prostatic lesions and utility of p63 and Alpha-methylacyl-Co A racemase immunohistochemical markers in resolving suspicious cases

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Original Article

Author Details : Syeda Khadija Fatima, Sharadrutha Alampally*, Anandam G

Volume : 6, Issue : 2, Year : 2019

Article Page : 275-283

https://doi.org/10.18231/j.ijpo.2019.053

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Abstract

Introduction: The spectrum of diseases affecting the prostate gland in men can be inflammatory, benign, premalignant lesions and malignancy. Major diagnostic challenge of surgical prostate biopsy interpretation is either due to a small focus of cancer or presence of various benign mimickers of malignancy which is labeled as suspicious foci. Aim of the study was to evaluate complete histopathological spectrum of lesions encountered on transrectal ultra sonography (TRUS) guided prostate needle biopsy and transurethral resection of prostate (TURP) chips and to use immunohistochemistry (IHC) markers like Alpha-methylacyl-Co enzyme A racemase (AMACR) and p63 as an adjunct in resolving the suspicious cases.
Materials and Methods: We assessed total 60 cases of prostatic specimens received during December 2015 to November 2017. The received specimens were routinely processed and histopathological examination was carried out. IHC for AMACR and p63 was performed and results were analyzed using SPSS software.
Results: Majority of cases were benign prostatic hyperplasia (BPH) (73.3%). Incidence of prostate cancer was low (16.6%). After IHC, out of the six (10%) histomorphologically suspicious cases, three cases were positive for only AMACR; two cases were positive for only p63 and one case showed positivity for both. Immunohistochemistry with AMACR and p63 proved to be highly sensitive markers for detecting malignancy but AMACR marker showed less specificity.
Conclusion: Histomorphologically, benign lesions of prostate are more common than malignant ones. Combination of AMACR and p63 IHC enhances the diagnostic accuracy in suspicious cases by identifying premalignant lesions or malignancy and reduces misdiagnosis.

Keywords: Histopathology, prostate cancer, suspicious foci, immunohistochemistry, AMACR, p63.

How to cite : Fatima S K, Alampally S, Anandam G, Histopathological spectrum of prostatic lesions and utility of p63 and Alpha-methylacyl-Co A racemase immunohistochemical markers in resolving suspicious cases. Indian J Pathol Oncol 2019;6(2):275-283

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