Atypical small acinar proliferation

DiseaseDisorder infobox
Name = Atypical small acinar proliferation
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eMedicineSubj = med
eMedicineTopic = 3056
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In urologic pathology, atypical small acinar proliferation, abbreviated ASAP, is a collection of small prostatic glands, on prostate biopsy, whose significance is uncertain and cannot be determined to be benign or malignant.

ASAP, generally, is "not" considered a pre-malignancy, or a carcinoma in situ; it is an expression of diagnostic uncertainty, [cite journal |author=Flury SC, Galgano MT, Mills SE, Smolkin ME, Theodorescu D |title=Atypical small acinar proliferation: biopsy artefact or distinct pathological entity |journal=BJU International |volume=99 |issue=4 |pages=780-5 |year=2007 |month=Jan |pmid= |doi= |url=http://www3.interscience.wiley.com/journal/118508438/abstract] and analogous to the diagnosis of ASCUS (atypical squamous cells of undetermined significance) on the Pap test.

Association with adenocarcinoma

On a subsequent biopsy, given the diagnosis of ASAP, the chance of finding prostate adenocarcinoma is approximately 40%; this is higher than if there is high-grade prostatic intraepithelial neoplasia (HGPIN). [cite journal |author=Leite KR, Camara-Lopes LH, Cury J, Dall'oglio MF, Sañudo A, Srougi M |title=Prostate cancer detection at rebiopsy after an initial benign diagnosis: results using sextant extended prostate biopsy |journal=Clinics |volume=63 |issue=3 |pages=339–42 |year=2008 |month=June |pmid=18568243 |doi= |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000300009&lng=en&nrm=iso&tlng=en]

Management

ASAP is considered an indication for re-biopsy. [cite journal |author=Bostwick DG, Meiers I |title=Atypical small acinar proliferation in the prostate: clinical significance in 2006 |journal=Arch. Pathol. Lab. Med. |volume=130 |issue=7 |pages=952–7 |year=2006 |month=July |pmid=16831049 |doi= |url=http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=0003-9985&volume=130&page=952]

ee also

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References


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