Periacinar retraction clefting in proliferative prostatic atrophy and prostatic adenocarcinoma

Aims: The purpose of this study was to evaluate the presence and extent of periacinar retraction clefting in proliferative prostatic atrophy and carcinoma in radical prostatectomy specimens. Methods: Atrophic foci and neoplastic glands were analysed in specimens from 50 patients who underwent radical prostatectomy. Analyzed atrophic glands were classified in two main groups, proliferative atrophy (PA) and proliferative inflammatory atrophy (PIA), and each group was subclassified into simple atrophy (SA) and postatrophic hyperplasia (PAH). According to the presence and extent of periacinar retraction clefting atrophic and neoplastic glands were classified as: group 1 - glands without clefts or with clefts affecting up to 50% of gland circumference, group 2 - glands with clefts that affected more than 50% of the circumference in less than 50% of examined glands and group 3 - glands with clefts that affected more than 50% of the circumference in more than 50% of examined glands. Results: Forty-four (88.0%) atrophic foci were without periacinar clefts or clefts were present in less than half of gland circumference (Group 1). In 6 (12.0%) atrophic foci clefts affected more than 50% of gland circumference (Groups 2 and 3). Forty-five (90.0%) carcinomas were with clefts which affected more than 50% of gland circumference (Groups 2 and 3), and only in five carcinomas clefts were not found or affected less than 50% of gland circumference (Group 1). Conclusion: Our results indicate that periacinar retraction clefting represents a reliable criterion in differential diagnosis between proliferative atrophy and carcinoma.