Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2022; 10(18): 6009-6020
Published online Jun 26, 2022. doi: 10.12998/wjcc.v10.i18.6009
Prostate sclerosing adenopathy: A clinicopathological and immunohistochemical study of twelve patients
Run-Lin Feng, Yan-Ping Tao, Zhi-Yong Tan, Shi Fu, Hai-Feng Wang
Run-Lin Feng, Department of Pathology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Yan-Ping Tao, Department of Emergency, Kunming Third People's Hospital, Kunming 650000, Yunnan Province, China
Zhi-Yong Tan, Shi Fu, Hai-Feng Wang, Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
Author contributions: Feng RL and Tan ZY contributed equally to this work; Feng RL, Tao YP, Fu S, and Wang HF designed the study; Tan ZY and Tao YP contributed new reagents and analytical tools; Tao YP, Fu S and Wang HF analyzed data; Feng RL and Tan ZY wrote the manuscript. All authors have read and approved the final manuscript.
Institutional review board statement: The study was authorized by the Ethics Committee at The Second Affiliated Hospital of Kunming Medical University.
Conflict-of-interest statement: The authors declared that no competing interests exist.
Data sharing statement: On reasonable request, the corresponding author will provide the analyzed datasets generated during the study.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed by the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Feng Wang, PhD, Chief Doctor, Department of Urology, The Second Affiliated Hospital of Kunming Medical University, No. 374 Yunnan-Burma Avenue, Kunming 650101, Yunnan Province, China. wanghaifeng@kmmu.edu.cn
Received: November 2, 2021
Peer-review started: November 2, 2021
First decision: April 7, 2022
Revised: April 19, 2022
Accepted: April 30, 2022
Article in press: April 30, 2022
Published online: June 26, 2022
Processing time: 226 Days and 13 Hours
Abstract
BACKGROUND

Although sclerosing adenopathy of the prostate is a very rare benign disease, an effective differential diagnosis is required. Here, we report the clinicopathological and immunohistochemical morphological features of 12 cases of sclerosing adenopathy of the prostate to improve understanding of the disease.

AIM

To investigate the clinicopathological features, diagnosis, and immunohistochemical phenotypes that distinguish prostate sclerosing adenopathy from other conditions.

METHODS

The clinical data, laboratory tests, pathological morphology, and immunohistochemical phenotypes of 12 cases of prostatic sclerosing adenopathy were retrospectively analyzed, and the relevant literature was reviewed.

RESULTS

All patients were elderly men (mean age, 71.7 years; 62–83 years). Eleven of them had hematuria, urinary frequency, urinary urgency, difficulty in urination, and serum total prostate-specific antigen values within the normal range. One patient had increased blood pressure. Enlarged prostates with single to multiple calcifying foci were observed. Moreover, prostate tissue hyperplastic changes were observed in all patients. Small follicular hyperplastic nodules without an obvious envelope, with a growth pattern mimicking the infiltration pattern of "prostate adenocarcinoma" were noted. Basal cells expressed AR, CKH, P63, and CK5/6, and myoepithelial markers, such as calponin, S100, and smooth muscle actin. No recurrence or exacerbation of the lesions was observed, except for one case of death due to bladder cancer.

CONCLUSION

Prostatic sclerosing adenopathy is highly misdiagnosed as prostate adenocarcinoma or other tumor-like lesions. Therefore, it should attract the attention of clinicopathologic researchers.

Keywords: Clinicopathology; Immunohistochemistry; Prostate disease; Sclerosing adenopathy

Core Tip: Sclerosing prostatic adenopathy is a rare pseudoadenocarcinoma proliferative lesion with a unique histomorphology and immunohistochemical phenotype. Compared to the common prostate adenocarcinoma, the incidence of sclerosing prostatic adenopathy is low, and we are under-recognized and have a high rate of misdiagnosis. Meanwhile, there are no large samples of data available to clinicopathologic to date because it is a rare lesion. To further our understanding of prostatic sclerosing adenopathy, this study aimed to investigate the histopathological morphology and immunohistochemical phenotype of this very rare prostate lesion and to further explore its associated biological significance.