Ano de Publicação: 2019
AUTORIA
Jennifer B. Gordetsky MDa,b,⁎, David Ullman MDa, Luciana Schultz MDc,
Kristin K. Porter MDd, Maria del Carmen Rodriguez Pena MDa, Carli E. Calderone MDb,
Jeffrey W. Nix MDb, Michael Ullman MDe, Sejong Bae PhDf,
Soroush Rais-Bahrami MDb,d
aDepartment of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
bDepartment of Urology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
cInstituto de Anatomia Patológica, Piracicaba, Santa Bárbara d’Oeste 13419-160, Brazil
dDepartment of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
eMedStar Georgetown University Hospital, Washington, DC 20007, USA
fDivision of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35249, USA
RESUMO
Magnetic resonance imaging (MRI)/ultrasound fusion–targeted biopsy (TB) has been shown to
more accurately identify higher-grade prostate cancers compared with standard-of-care systematic sextant
prostate biopsy (SB). However, occasional false-positive imaging findings occur. We investigated the histologic
findings associated with false-positive prostateMRI findings. A retrospective review was performed
on our surgical pathology database from 2014 to 2017 selecting patients with no cancer detected on TB with
concurrent SB after at least 1 prior benign SB session. Histologic features evaluated included percentage of
core involvement by chronic inflammation, percentage of core composed of stroma, percentage of glands
involved by atrophy, and presence of the following features: acute or granulomatous inflammation, stromal
nodular hyperplasia, adenosis, squamous metaplasia, basal cell hyperplasia, and presence of skeletal muscle.
Histologic findings were compared between TB and concurrent SB.We identified 544 patients who underwent
TB. Of these, 41 patients, including 62 targeted lesions, met criteria. Compared with SB tissue, the
mean percentage of stroma was increased in TB (P = .02). Basal cell hyperplasia was also found to be more
common on TB (P = .02). Both high percentage of stroma (P = .046) and presence of basal cell hyperplasia
(P = .038) were independent predictors on multivariate analysis. The combination of high chronic inflammation,
high stroma, acute inflammation, and basal cell hyperplasia was associated with TB (P = .001).