Open Access Gateway
Med Princ Pract 2010;19:82–85
(DOI:10.1159/000252842)

Prostatic Ductal Adenocarcinoma: A Mini Review

Epstein J.I.
Departments of Pathology, Urology, and Oncology, The Johns Hopkins Hospital, Baltimore, Md., USA
email Corresponding Author


 goto top of outline Key Words

  • Prostate adenocarcinoma
  • Ductal adenocarcinoma
  • Gleason grade

 goto top of outline Abstract

Prostatic ductal adenocarcinomas may arise either in large primary periurethral prostatic ducts or in the peripheral prostatic ducts. Ductal adenocarcinomas are composed of tall columnar cells arranged in cribriform, papillary, solid, single glands, and PIN-like patterns. Other than the prostatic intraepithelial neoplasia (PIN)-like ductal pattern, which behaves like Gleason pattern 3, ductal adenocarcinoma is comparable to Gleason pattern 4 prostate cancer. Ductal adenocarcinoma can have a patchy basal cell layer and typically expresses prostate-specific antigen (PSA) immunohistochemically. Mimickers of ductal adenocarcinoma include prostatic urethral polyps, hyperplastic benign prostate glands, high-grade PIN, colorectal adenocarcinoma, and papillary urothelial carcinoma.

Copyright © 2009 S. Karger AG, Basel


 goto top of outline References
  1. Brinker DA, Potter SR, Epstein JI: Ductal adenocarcinoma of the prostate diagnosed on needle biopsy: correlation with clinical and radical prostatectomy findings and progression. Am J Surg Pathol 1999;23:1471–1479.
  2. Bostwick DG, Kindrachuk RW, Rouse RV: Prostatic adenocarcinoma with endometrioid features: clinical, pathologic, and ultrastructural findings. Am J Surg Pathol 1985;9:595–609.
  3. Christensen WN, Steinberg G, Walsh PC, Epstein JI: Prostatic duct adenocarcinoma: findings at radical prostatectomy. Cancer 1991;67:2118–2124.
  4. Epstein JI, Woodruff JM: Adenocarcinoma of the prostate with endometrioid features: a light microscopic and immunohistochemical study of ten cases. Cancer 1986;57:111–119.
  5. Greene LF, Farrow GM, Ravits JM, Tomera FM: Prostatic adenocarcinoma of ductal origin. J Urol 1979;121:303–305.
  6. Melicow MM, Tannenbaum M: Endometrial carcinoma of uterus masculinus (prostatic utricle): report of 6 cases. J Urol 1971;106:892–902.
  7. Hameed O, Humphrey PA: Stratified epithelium in prostatic adenocarcinoma: a mimic of high-grade prostatic intraepithelial neoplasia. Mod Pathol 2006;19:899–906.
  8. Tavora F, Epstein JI: High-grade prostatic intraepithelial neoplasia-like ductal adenocarcinoma of the prostate: a clinicopathologic study of 28 cases. Am J Surg Pathol 2008;32:1060–1067.
  9. Herawi M, Epstein JI: Immunohistochemical antibody cocktail staining (p63/HMWCK/AMACR) of ductal adenocarcinoma and Gleason pattern 4 cribriform and noncribriform acinar adenocarcinomas of the prostate. Am J Surg Pathol 2007;31:889–894.
  10. Samaratunga H, Singh M: Distribution pattern of basal cells detected by cytokeratin 34 beta E12 in primary prostatic duct adenocarcinoma. Am J Surg Pathol 1997;21:435–440.
  11. Owens CL, Epstein JI, Netto GJ: Distinguishing prostatic from colorectal adenocarcinoma on biopsy samples: the role of morphology and immunohistochemistry. Arch Pathol Lab Med 2007;131:599–603.
  12. Grignon DJ: Unusual subtypes of prostate cancer. Mod Pathol 2004;17:316–327.
  13. Hameed O, Humphrey PA: Immunohistochemistry in diagnostic surgical pathology of the prostate. Semin Diagn Pathol 2005;22:88–104.
  14. Mai KT, Collins JP, Veinot JP: Prostatic adenocarcinoma with urothelial (transitional cell) carcinoma features. Appl Immunohistochem Mol Morphol 2002;10:231–236.
  15. Oxley J, Abbott C. Thrombomodulin immunostaining and ductal carcinoma of the prostate. Histopathology 1998;33:391–392.
  16. Tu SM, Reyes A, Maa A, Bhowmick D, Pisters LL, Pettaway CA, Lin SH, Troncoso P, Logothetis CJ: Prostate carcinoma with testicular or penile metastases. Clinical, pathologic, and immunohistochemical features. Cancer 2002;94:2610–2617.
  17. Copeland JN, Amin MB, Humphrey PA, Tamboli P, Ro JY, Gal AA: The morphologic spectrum of metastatic prostatic adenocarcinoma to the lung: special emphasis on histologic features overlapping with other pulmonary neoplasms. Am J Clin Pathol 2002;117:552–557.
  18. Ro JY, Ayala AG, Wishnow KI, Ordóñez NG: Prostatic duct adenocarcinoma with endometrioid features: immunohistochemical and electron microscopic study. Semin Diagn Pathol 1988;5:301–311.
  19. Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL, ISUP Grading Committee: The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol 2005;29:1228–1242.

 goto top of outline Author Contacts

Prof. Jonathan I. Epstein
Departments of Pathology, Urology, and Oncology, The Johns Hopkins Hospital
600 N. Wolfe Street
Baltimore, MD 21287 (USA)
Tel. +1 410 955 5043, Fax +1 410 955 0115, E-Mail jepstein@jhmi.edu


 goto top of outline Article Information

Received: May 17, 2009
Revised: May 21, 2009
Published online: December 09, 2009
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 0, Number of References : 19


 goto top of outline Publication Details

Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre)

Vol. 19, No. 1, Year 2010 (Cover Date: December 2009)

Journal Editor: Owunwanne A. (Kuwait)
ISSN: 1011-7571 (Print), eISSN: 1423-0151 (Online)

For additional information: http://www.karger.com/MPP


Open Access License / Drug Dosage / Disclaimer

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.