Proposed morphologic classification of prostate cancer with neuroendocrine differentiation
Jonathan I Epstein1, Mahul B Amin, Himisha Beltran
1Departments of *Pathology †Urology ‡Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD §Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA Departments of ∥Medicine ¶Pathology and Laboratory Medicine #Institute for Precision Medicine, Weill Medical College of Cornell University and New York-Presbyterian Hospital **Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY ††Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Abstract:
On July 31, 2013, the Prostate Cancer Foundation assembled a working committee on the molecular biology and pathologic classification of neuroendocrine (NE) differentiation in prostate cancer. New clinical and molecular data emerging from prostate cancers treated by contemporary androgen deprivation therapies, as well as primary lesions, have highlighted the need for refinement of diagnostic terminology to encompass the full spectrum of NE differentiation. The classification system consists of: Usual prostate adenocarcinoma with NE differentiation; 2) Adenocarcinoma with Paneth cell NE differentiation; 3) Carcinoid tumor; 4) Small cell carcinoma; 5) Large cell NE carcinoma; and 5) Mixed NE carcinoma - acinar adenocarcinoma. The article also highlights "prostate carcinoma with overlapping features of small cell carcinoma and acinar adenocarcinoma" and "castrate-resistant prostate cancer with small cell cancer-like clinical presentation". It is envisioned that specific criteria associated with the refined diagnostic terminology will lead to clinically relevant pathologic diagnoses that will stimulate further clinical and molecular investigation and identification of appropriate targeted therapies.
