Histologic Criteria for Low and High Grade PIN (Modified Criteria of Bostwich and Brawer)

Description

Prostatic intraepitheal neoplasia (PIN) can be identified in histologic sections based on specific criteria. Initially PIN was separated into 3 grades (PIN-1, PIN-2, PIN-3) but was later consolidated into low (PIN-1) and high grades (PIN-2 and PIN-3).

Parameters:

(1) cellular crowding, stratification and crowding (absent or present)

(2) nuclear enlargement with variation in size (absent or present)

(3) chromatin (normal, or dense and clumped)

(4) nucleoli (absent or small vs prominent)

(5) basal cellular layer (intact vs disrupted)

(6) basement membrane (intact vs disrupted)

(7) abnormal glandular pattern (tufting, micropapillary, cribriform, flat)

Diagnosis	Histologic Features
negative for PIN	no or minimal cellular crowding or stratification no nuclear enlargement normal chromatin no prominent nucleoli basal cellular layer intact basement membrane intact no abnormal glandular patterns
low grade PIN	cellular crowding and stratification nuclear enlargement normal chromatin no or rare prominent nucleoli basal layer intact basement membrane intact no abnormal glandular patterns
high grade PIN	cellular crowding and stratification nuclear enlargement chromatin dense and clumped prominent nucleoli basal layer may be intact or disrupted basement membrane intact abnormal glandular pattern present
prostate adenocarcinoma	prominent nucleoli disrupted basement membrane

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Histologic Criteria for Low and High Grade PIN (Modified Criteria of Bostwich and Brawer)

Description

Specialty