[Importance of second opinions on histology of prostate biopsy specimens].
OBJECTIVE
The significance of a second opinion on the histological findings of prostate carcinomas as well as suspicious lesions on core needle biopsy specimens was studied in cases from the year 2008.


METHODS
A total of 920 core needle biopsy specimens of the prostate were stained with H & E and when necessary immunohistochemical analyses were performed with basal cell markers p63, 34ßE12, PSA and AMACR (P504 S) and neuroendocrine markers such as synaptophysin and chromogranin. The modified Gleason grading system was used.


RESULTS
In 43.5% of suspicious lesions adenocarcinomas of the prostate were found. In 53.2% the findings of atypical small acinar proliferations or high-grade prostatic intraepithelial neoplasia (HGPIN) were confirmed with a recommendation of serum PSA and morphological controls. The suspicion of prostatic carcinoma could be confirmed in 87.2% by the diagnosis of adenocarcinoma. After Gleason grading 82.8% of all diagnosed carcinomas had scores 6 or 7(3 + 4) and belonged to the group of low grade carcinomas. High grade carcinomas were without diagnostic problems.


CONCLUSIONS
A second opinion on the histological analysis of suspicious lesions of the prostate as well as of confirmation of Gleason grading is a very important point of quality management of diagnostic steps of prostate carcinomas and may be helpful for different therapeutic strategies.
Schwerpunkt Uropathologie, Institut für Pathologie, HBH-Kliniken Singen, Akademisches Lehrkrankenhaus der Universität Freiburg, Postfach 720, 78207, Singen, Deutschland. burkhard.helpap@hbh-kliniken.de
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Oehler
D061354:Acinar Cells / Q000473:pathology; D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D001707:Biopsy, Needle; D049109:Cell Proliferation; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000473:pathology; D019048:Prostatic Intraepithelial Neoplasia / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen