Prostatic stromal proliferations: a review.
David G Bostwick1, Lars Egevad2
1Bostwick Laboratories, A Division of Poplar Healthcare, Orlando, FL, USA.
Pathology
|November 16, 2020
Summary
Prostatic stromal proliferations are common benign lesions, but some variants and rare malignant tumors like rhabdomyosarcoma and leiomyosarcoma require careful diagnosis. This review offers a modern classification and diagnostic approach for prostatic stromal tumors.
Area of Science:
- Urology
- Pathology
- Oncology
Background:
- Prostatic stromal proliferations are frequent benign lesions, with nodular hyperplasia being most common in elderly men.
- Certain variants, such as stromal hyperplasia with atypia, present diagnostic challenges due to myofibroblast changes.
- Malignant prostatic stromal tumors are rare (<0.1% of malignancies), with rhabdomyosarcoma and leiomyosarcoma being most frequent.
Purpose of the Study:
- To present a contemporary classification of prostatic stromal tumors.
- To outline diagnostic strategies for prostatic stromal lesions.
- To address the challenges in differentiating benign from malignant stromal tumors.
Main Methods:
- Review of current literature on prostatic stromal lesions.
- Analysis of classification systems for prostatic stromal tumors.
- Discussion of diagnostic criteria for benign and malignant stromal neoplasms.
Main Results:
- Nodular hyperplasia is the predominant benign prostatic stromal proliferation.
- Malignant stromal tumors are rare, with distinct pediatric and adult forms.
- A unified classification approach for tumors of uncertain malignant potential is discouraged.
Conclusions:
- Accurate classification and diagnosis of prostatic stromal tumors are crucial.
- Distinguishing benign from malignant stromal lesions requires careful pathological assessment.
- This review provides an updated framework for managing prostatic stromal tumors.
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