High-grade prostatic intraepithelial neoplasia (HGPIN)

[@jenishpatel7886]

Thank you Dr Shah for the practical tips, very useful in routine prostate biopsy reporting

[@rajalbshahExperturologicpath]

Thank you Payal! I appreciate your feedback!

[@Simon-si3ec]

Thank you Dr. Shah! I finished my GU rotation last week but couldn't help but look at these nice pearls today!

[@rajalbshahExperturologicpath]

Thanks, Simon! Thank you for encouraging comments. Please do let your other friends and colleagues about the channel. Hope to meet you in near future. Best wishes.

[@leeritz8368]

I love this format! Thank you for sharing your GU path wisdom! Looking forward to more!

[@rajalbshahExperturologicpath]

Thank you very much Lee! I appreciate the feedback

[@BahayMagica]

Excellent slide presentation Dr. Shah. Is it still true today that the predictive value of HGPIN has declined significantly now 6 years after this video?

[@rajalbshahExperturologicpath]

Yes, the predictive value of HGPIN has significantly declined in recent years. The Video is not six years old though!

[@07337157]

Thanks Dr. Shah for nice and concise review

[@rajalbshahExperturologicpath]

Thank you, sohail!

[@lehu8529]

Great Video! 2 short questions 1) What do you mean by non-luminal proliferation of nuclei at 8:00? 2) Concerning basal cells in PIN-like prostate cancer at 8:40: So in this type of prostate cancer it seems like the basal cells are preserved when they actually aren’t, which we prove with immunohistochemical staining for PIN4 (did I understand that correctly?).. and in comparison in “classical” prostate cancer we would see a scarceness of basal nuclei?

[@rajalbshahExperturologicpath]

Le, thank you for your feedback and questions. Regarding #1 I mean in basal cell hyperplasia cells are proliferating towards the peripheral aspect of gland while in PIN proliferating cells are secretory type which proliferate towards the lumen

[@rajalbshahExperturologicpath]

Regarding 2 basal cells are not preserved in PIN-like cancers. Proliferating cells are secretory type

[@lehu8529]

@@rajalbshahExperturologicpath Regarding 1) Got it, thank you very much!

[@lehu8529]

@@rajalbshahExperturologicpath Regarding 2) Ye that’s what I meant, thank you!

[@SandhyaRamachandran]

Thanks so much Dr Shah for sharing these pearls ! extremely helpful !! At 11:26, is it necessary to mention AIP when there is adjacent Invasive cancer. Yes we do it in Ca breast cases but I hv never done it in Ca prostate.TIA.

[@rajalbshahExperturologicpath]

I mention AIP specifically when invasive cancer is grade group 1 and 2

[@rajalbshahExperturologicpath]

Thank you Sandhya for the feedback! I appreciate it. Please share with your colleagues.

[@SandhyaRamachandran]

@@rajalbshahExperturologicpath Thank u Dr Rajal.. yes that looks good :)

[@SandhyaRamachandran]

Dr Shah, what Gleason pattern should we assign a PIN-like Prostate ca...how frequently do you see it ? Thank you.

[@rajalbshahExperturologicpath]

PIN-like prostate cancer is graded as pattern 3. It can have Ductal or acinar forms. Ductal is quite uncommon but acinar form in my experience is not uncommon.

[@SandhyaRamachandran]

@@rajalbshahExperturologicpath Thank you for the clarification!

[@God_is_my_savior-316]

20x not 200x correct?

[@rajalbshahExperturologicpath]

Yes, correct. That is what I mean. 20x lens 200 magnification

[@SandhyaRamachandran]

I dont have a 20x objective :):) is this a strict criterion ? please...

[@rajalbshahExperturologicpath]

This criteria is widely utilized. But one should not necessarily be rigid regarding the nucleoli as it is subjected to both tissue fixation and thickness of the section. Therefore, it varies between laboratory. As long as you can build your own internal threshold which correlates with this criteria, it may be OK

[@SandhyaRamachandran]

@@rajalbshahExperturologicpath Thank u for the reply!

[@God_is_my_savior-316]

2x objective x 10x=20x

[@SandhyaRamachandran]

@@God_is_my_savior-316 I am referring to 20x objective ! not 20 x magnification