title: Intraductal carcinoma of prostate reporting practice: a survey of expert European uropathologists.
abstract: BACKGROUND
  It is unclear whether the reported variation in the diagnosis of intraductal carcinoma of the prostate (IDC-P) is due to variable interpretation of borderline morphology, use of different diagnostic criteria or both.
  
  
  OBJECTIVE
  We sought to determine the degree of variation in the diagnostic criteria and reporting rules for IDC-P in prostate biopsies employed by expert uropathologists.
  
  
  METHODS
  A questionnaire survey was circulated to 23 expert uropathologists from 11 European countries.
  
  
  RESULTS
  Criteria used for diagnosis of IDC-P included solid intraductal growth (100%), dense cribriform (96%), loose cribriform/micropapillary with nuclear size >6× normal (83%) or comedonecrosis (74%) and dilated ducts >2× normal (39%). 'Nuclear size' was interpreted as nuclear area by 74% and nuclear diameter by 21%. Pure IDC-P in needle biopsies was reported by 100% and Gleason graded by 30%. All would perform immunohistochemistry in such cases to rule out invasive cancer. An IDC-P component associated with invasive cancer would be included in the determination of tumour extent and number of cores involved by 74% and 83%, respectively. 52% would include IDC-P component when grading invasive cancer. 48% would perform immunohistochemistry in solid or cribriform nests with comedonecrosis to exclude IDC-P (17% routinely, 30% if the focus appeared to have basal cells on H&E). 48% graded such foci as Gleason pattern 5 even if immunohistochemistry demonstrated the presence of basal cells.
  
  
  CONCLUSIONS
  There is a need for more clarity in the definition of some of the diagnostic criteria for IDC-P as well as for greater standardisation of IDC-P reporting.
authors.affiliation: Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK.
authors.forename: Murali
authors.initials: M
authors.lastname: Varma
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
authors.affiliation: Department of Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Algaba
authors.affiliation: Department of Molecular Oncology, Queen Mary University Hospital, London, UK.
authors.forename: Daniel
authors.initials: D
authors.lastname: Berney
authors.affiliation: Institut fur Pathologie, Universitatsspital Basel, Basel, Switzerland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Bubendorf
authors.affiliation: Department of Pathology, Centre de Pathologie Amiens, Amiens, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Camparo
authors.affiliation: Department of Pathology, Hôpital La Pitié-Salpêtrière, Paris, France.
authors.forename: Eva
authors.initials: E
authors.lastname: Comperat
authors.affiliation: Department of Pathology, Universität of Rostock, Rostock, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Erbersdobler
authors.affiliation: Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK.
authors.forename: David
authors.initials: D
authors.lastname: Griffiths
authors.affiliation: Institute of Pathology, Kantonsspital Aarau, Aarau, Switzerland.
authors.forename: Rainer
authors.initials: R
authors.lastname: Grobholz
authors.affiliation: Department of Clinical Pathology, Medizinische Universitat Wien, Wien, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Haitel
authors.affiliation: Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Christina
authors.initials: C
authors.lastname: Hulsbergen-van de Kaa
authors.affiliation: Institute of Pathology, Medical University Graz, Graz, Austria.
authors.forename: Cord
authors.initials: C
authors.lastname: Langner
authors.affiliation: Department of Cellular Pathology, Tallaght Hospital, Dublin, Ireland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Loftus
authors.affiliation: Department of Pathology, Champalimaud Clinical Center, Lisbon, Portugal.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lopez-Beltran
authors.affiliation: Department of Pathology, Cork University Hospital Group, Cork, Ireland.
authors.forename: Nick
authors.initials: N
authors.lastname: Mayer
authors.affiliation: Department of Pathological Anatomy, University of Florence, Florence, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Nesi
authors.affiliation: Department of Pathology, Hospital Da Luz, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Oliveira
authors.affiliation: Department of Cellular Pathology, Southmead Hospital, Bristol, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Oxley
authors.affiliation: Department of Pathology, Rennes Hospital, Rennes, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rioux-Leclercq
authors.affiliation: Institute of Pathology, Sozialstiftung Bamberg, Bamberg, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Seitz
authors.affiliation: Department of Histopathology, The Christie NHS Foundation Trust, Manchester, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shanks
authors.affiliation: Institute of Pathology, University Hospital Bonn, Bonn, Germany.
authors.forename: Glen
authors.initials: G
authors.lastname: Kristiansen
mesh_terms: D001707:Biopsy, Needle; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000175:diagnosis*; D005060:Europe; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D060787:Neoplasm Grading; D000072142:Pathologists; D011467:Prostate / Q000473:pathology*; D019048:Prostatic Intraepithelial Neoplasia / Q000175:diagnosis*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: GENITOURINARY PATHOLOGY; HISTOPATHOLOGY; PROSTATE; UROPATHOLOGY