title: Ductal and Acinar Adenocarcinoma of Prostate: Morphological and Immunohistochemical Characterization.
abstract: OBJECTIVE
  We sought to characterize the ductal and acinar subtype of prostate adenocarcinoma using hematoxylin and eosin (H&E) staining and an immunohistochemical antibody cocktail. We also investigated the clinical features, prostate-specific antigen (PSA) levels, and biological aggressiveness of these tumors.
  
  
  METHODS
  We utilized tumor bearing prostate biopsies, obtained between 2010 and 2014 from Dow Diagnostic Research and Reference Laboratory, to identify cases of prostatic ductal and acinar adenocarcinoma using routine H&E and immunohistochemical staining. The immunohistochemical antibody cocktail 34βE12/p63/AMACR was used for staining. The association of clinicopathological variables including patient's age at diagnosis, Gleason score, and PSA levels before surgery was retrospectively analyzed.
  
  
  RESULTS
  A total of 10 ductal and 140 non-ductal cases were identified. Ductal cases were predominantly high grade with advanced histopathological features (90%; p=0.030). Marked elevation in PSA level was also reported in most cases. No other significant statistical difference was observed.
  
  
  CONCLUSIONS
  Pathological and immunohistochemical examination could be used to characterize ductal and acinar adenocarcinoma of the prostate. Ductal adenocarcinoma of the prostate is a rare subtype of prostate carcinoma and is be more likely to present with advanced grade cancer suggesting that timely detection of the disease is vital.
authors.affiliation: Department of Pathology, Ziauddin University, Karachi, Pakistan.
authors.forename: Faraz A
authors.initials: FA
authors.lastname: Baig
authors.affiliation: Department of Medicine, Ziauddin University Hospital, Karachi, Pakistan.
authors.forename: Amna
authors.initials: A
authors.lastname: Hamid
authors.affiliation: Department of Pathology, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Talat
authors.initials: T
authors.lastname: Mirza
authors.affiliation: Department of Pathology, Ziauddin University, Karachi, Pakistan.
authors.forename: Serajuddaula
authors.initials: S
authors.lastname: Syed
keywords: Acinar Carcinoma; Adenocarcinoma; Ductal Carcinoma; Gleason Score; Immunohistochemistry; Prostate