How are precancerous lesions of the prostate diagnosed?

Updated: Feb 26, 2020
  • Author: Stanley A Brosman, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

Only prostate biopsy can be used to identify HGPIN or ASAP. [26] Neither type of lesion alone causes symptoms, and therefore, no physical examination findings reveal the presence of PIN or ASAP. The PSA and other tumor markers such as Exosome and Decipher do not assist when HGPIN or ASAP is present.

The prostate may be enlarged secondary to BPH, but this is unrelated to HGPIN. Areas in the prostate may have palpable nodules, or other areas may indicate cancer. None of these physical findings suggests the presence of HGPIN or ASAP.

Some pathologists may note that a small focus of atypical glands has been identified in a biopsy specimen but that, although the finding is suspicious for cancer, not enough cytologic or architectural atypia are present to diagnose cancer. In this scenario, the pathologist usually suggests that another biopsy be performed.

Neither HGPIN nor ASAP seems to affect PSA production, meaning that PSA evaluation cannot be used to detect or to monitor the progression of these entities. In addition, neither HGPIN nor ASAP are readily detectable with any imaging technology.


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