Atypical small acinar proliferation explained

Atypical small acinar proliferation
Synonyms:	ASAP

In urologic pathology, atypical small acinar proliferation, is a collection of small prostatic glands, on prostate biopsy, whose significance is uncertain and cannot be determined to be benign or malignant.

ASAP, generally, is not considered a pre-malignancy, or a carcinoma in situ; it is an expression of diagnostic uncertainty,^[1] and analogous to the diagnosis of ASCUS (atypical squamous cells of undetermined significance) on the Pap test.

Association with adenocarcinoma

On a subsequent biopsy, given the diagnosis of ASAP, the chance of finding prostate adenocarcinoma is approximately 40%; this is higher than if there is high-grade prostatic intraepithelial neoplasia (HGPIN).^[2]

Management

ASAP is considered an indication for re-biopsy;^[3] in one survey of urologists^[4] 98% of respondents considered it a sufficient reason to re-biopsy.

See also

• Sensitivity

Notes and References

1. Flury SC, Galgano MT, Mills SE, Smolkin ME, Theodorescu D . Atypical small acinar proliferation: biopsy artefact or distinct pathological entity . BJU International . 99 . 4 . 780–5 . January 2007 . 17378841. 10.1111/j.1464-410X.2006.06703.x. 30734977 . https://archive.today/20130105052734/http://www3.interscience.wiley.com/journal/118508438/abstract. dead. 2013-01-05.
2. Leite KR, Camara-Lopes LH, Cury J, Dall'oglio MF, Sañudo A, Srougi M . Prostate cancer detection at rebiopsy after an initial benign diagnosis: results using sextant extended prostate biopsy . Clinics . 63 . 3 . 339–42 . June 2008 . 18568243 . 10.1590/S1807-59322008000300009. 2664245.
3. Bostwick DG, Meiers I . Atypical small acinar proliferation in the prostate: clinical significance in 2006 . Arch. Pathol. Lab. Med. . 130 . 7 . 952–7 . July 2006 . 16831049 . 10.5858/2006-130-952-ASAPIT.
4. Rubin MA, Bismar TA, Curtis S, Montie JE . Prostate needle biopsy reporting: how are the surgical members of the Society of Urologic Oncology using pathology reports to guide treatment of prostate cancer patients? . Am. J. Surg. Pathol. . 28 . 7 . 946–52 . July 2004 . 15223967 . 10.1097/00000478-200407000-00016. 12886636 .