title: Seminal epithelium in prostate biopsy can mimic malignant and premalignant prostatic lesions.
abstract: OBJECTIVE
  In most prostate biopsies, the seminal epithelium is easily recognised because it meets characteristic histological criteria. However, some biopsies can mimic malignant or premalignant prostatic lesions. The aims of this study were to analyse the histological appearance of the biopsies that mimic adenocarcinomas or preneoplastic prostatic lesions, discuss the differential diagnosis and determine the frequency of seminal epithelia in prostate biopsies.
  
  
  METHODS
  We consecutively reviewed 500 prostate puncture biopsies obtained using the sextant method and selected those cases in which we observed seminal vesicle or ejaculatory duct epithelium. In the biopsies in which the seminal epithelium resembled malignant or premalignant lesions, immunohistochemical studies were conducted that included prostate-specific antigen and MUC6. The most important clinical data were recorded.
  
  
  RESULTS
  Thirty-six (7.2%) biopsies showed seminal epithelium, and 7 of them (1.4%) resembled various prostate lesions, including high-grade prostatic intraepithelial neoplasia, atypical acinar proliferations, adenocarcinomas with papillary patterns and poorly differentiated carcinoma. The seminal epithelium resembled prostate lesions when the lipofuscin deposit, the perinuclear vacuoles or the nuclear pseudoinclusions were inconspicuous or missing. Five of the 7 biopsies showed mild to moderate cellular atypia with small and hyperchromatic nuclei, and only 2 showed cellular pleomorphism. The patients were alive and asymptomatic after an average of 6 years of progression.
  
  
  CONCLUSIONS
  The seminal epithelium resembles prostatic intraepithelial neoplasia, atypical acinar proliferations and various types of prostatic adenocarcinomas in approximately 1.4% of prostate biopsies.
authors.affiliation: Departamento de Patología, Instituto Nacional de Nutrición, Salvador Zubirán Vasco de Quiroga, México D.F., México.
authors.forename: J
authors.initials: J
authors.lastname: Arista-Nasr
authors.affiliation: Departamento de Patología, Instituto Nacional de Nutrición, Salvador Zubirán Vasco de Quiroga, México D.F., México.
authors.forename: A
authors.initials: A
authors.lastname: Trolle-Silva
authors.affiliation: Departamento de Patología, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Unidad de Enlace, Centro de Apoyo Diagnostico «San Rafael», México D.F., México.
authors.forename: E
authors.initials: E
authors.lastname: Aguilar-Ayala
authors.affiliation: Departamento de Patología, Instituto Nacional de Nutrición, Salvador Zubirán Vasco de Quiroga, México D.F., México. Electronic address: brauliomb77@yahoo.com.mx.
authors.forename: B
authors.initials: B
authors.lastname: Martínez-Benítez
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D004848:Epithelium / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012669:Seminal Vesicles / Q000473:pathology*
keywords: Atypical small acinar proliferation; Biopsia por punción; Epitelio seminal; False positive results; Neoplasia intraepitelial prostática; Proliferaciones acinares atípicas; Prostate; Prostatic intraepithelial neoplasia; Próstata; Puncture biopsy; Resultados falsos positivos; Seminal epithelium