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Related Experiment Video

Updated: Jul 2, 2026

Enhancing Prostate Tumor Biobanking Reliability with Improved Sampling Technique and Histological Characterization
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Do prostatic transition zone tumors have a distinct morphology?

Joaquin J Garcia1, Hikmat A Al-Ahmadie, Anuradha Gopalan

  • 1Department of Pathology, Memorial Sloan Kettering Cancer Center, New York City, NY 10021, USA.

The American Journal of Surgical Pathology
|September 5, 2008
PubMed
Summary

The transition zone look (TZ-LOOK) morphology is more common in transition zone (TZ) prostate tumors than peripheral zone (PZ) tumors. However, its presence, especially when nonfocal, requires caution when determining tumor origin from limited prostate biopsy samples.

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Area of Science:

  • Uropathology
  • Prostate Cancer Histopathology
  • Tumor Zonal Origin

Background:

  • The transition zone look (TZ-LOOK) morphology, characterized by specific glandular and cellular features, has been proposed as indicative of well-to-moderately differentiated transition zone (TZ) prostate tumors.
  • The diagnostic specificity of TZ-LOOK for determining the zonal origin of prostate tumors, particularly in distinguishing between TZ and peripheral zone (PZ) lesions, remains incompletely understood.

Purpose of the Study:

  • To evaluate the prevalence of TZ-LOOK morphology in prostate tumors originating from different zonal locations (TZ and PZ).
  • To assess the diagnostic utility and specificity of TZ-LOOK morphology in identifying the zonal origin of dominant prostate tumors using radical prostatectomy specimens.

Main Methods:

  • Histopathologic analysis of 215 dominant prostate tumors from radical prostatectomy specimens, including 63 TZ tumors and 152 PZ tumors.

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Last Updated: Jul 2, 2026

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  • Quantification of TZ-LOOK morphology using a 0-4 extent score (0=none, 1=1-25%, 2=26-50%, 3=51-75%, 4=>75%).
  • Statistical comparison of TZ-LOOK prevalence and extent between TZ and PZ tumors.

    • Main Results:

    • Overall, 56% of tumors exhibited some degree of TZ-LOOK morphology; 89% of TZ tumors and 43% of PZ tumors showed this feature (P<0.0001).
    • Predominant TZ-LOOK (scores 3-4, >50%) was observed in 17% of all tumors, predominantly in TZ tumors (84%).
    • Nonfocal TZ-LOOK (scores 2-3, >25%) was present in 15% of PZ tumors, and 35% of PZ tumors with any TZ-LOOK showed nonfocal involvement.

    Conclusions:

    • While TZ-LOOK morphology is more frequent in TZ tumors, its presence alone is not definitive for zonal origin, especially in PZ tumors.
    • Predominant TZ-LOOK (>50%) strongly suggests TZ origin, but occurs in only half of TZ tumors.
    • The nonfocal presence of TZ-LOOK in a significant proportion of PZ tumors necessitates caution when interpreting prostate needle biopsies.