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Intraductal carcinoma of prostate reporting practice: a survey of expert European uropathologists
  1. Murali Varma1,
  2. Lars Egevad2,
  3. Ferran Algaba3,
  4. Daniel Berney4,
  5. Lukas Bubendorf5,
  6. Philippe Camparo6,
  7. Eva Comperat7,
  8. Andreas Erbersdobler8,
  9. David Griffiths1,
  10. Rainer Grobholz9,
  11. Andrea Haitel10,
  12. Christina Hulsbergen-van de Kaa11,
  13. Cord Langner12,
  14. Barbara Loftus13,
  15. Antonio Lopez-Beltran14,
  16. Nick Mayer15,
  17. Gabriella Nesi16,
  18. Pedro Oliveira17,
  19. Jon Oxley18,
  20. Nathalie Rioux-Leclercq19,
  21. Gerhard Seitz20,
  22. Jonathan Shanks21,
  23. Glen Kristiansen22
  1. 1Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
  2. 2Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Pathology, Fundacio Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
  4. 4Department of Molecular Oncology, Queen Mary University Hospital, London, UK
  5. 5Institut fur Pathologie, Universitatsspital Basel, Basel, Switzerland
  6. 6Department of Pathology, Centre de Pathologie Amiens, Amiens, France
  7. 7Department of Pathology, Hôpital La Pitié-Salpêtrière, Paris, France
  8. 8Department of Pathology, Universität of Rostock, Rostock, Germany
  9. 9Institute of Pathology, Kantonsspital Aarau, Aarau, Switzerland
  10. 10Department of Clinical Pathology, Medizinische Universitat Wien, Wien, Austria
  11. 11Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
  12. 12Institute of Pathology, Medical University Graz, Graz, Austria
  13. 13Department of Cellular Pathology, Tallaght Hospital, Dublin, Ireland
  14. 14Department of Pathology, Champalimaud Clinical Center, Lisbon, Portugal
  15. 15Department of Pathology, Cork University Hospital Group, Cork, Ireland
  16. 16Department of Pathological Anatomy, University of Florence, Florence, Italy
  17. 17Department of Pathology, Hospital Da Luz, Lisboa, Portugal
  18. 18Department of Cellular Pathology, Southmead Hospital, Bristol, UK
  19. 19Department of Pathology, Rennes Hospital, Rennes, France
  20. 20Institute of Pathology, Sozialstiftung Bamberg, Bamberg, Germany
  21. 21Department of Histopathology, The Christie NHS Foundation Trust, Manchester, UK
  22. 22Institute of Pathology, University Hospital Bonn, Bonn, Germany
  1. Correspondence to Dr Murali Varma, Department of Cellular Pathology, University Hospital of Wales, Heath Park, Cardiff CF14 4XN, UK; wptmv{at}


Background It is unclear whether the reported variation in the diagnosis of intraductal carcinoma of the prostate (IDC-P) is due to variable interpretation of borderline morphology, use of different diagnostic criteria or both.

Aims We sought to determine the degree of variation in the diagnostic criteria and reporting rules for IDC-P in prostate biopsies employed by expert uropathologists.

Methods A questionnaire survey was circulated to 23 expert uropathologists from 11 European countries.

Results Criteria used for diagnosis of IDC-P included solid intraductal growth (100%), dense cribriform (96%), loose cribriform/micropapillary with nuclear size >6× normal (83%) or comedonecrosis (74%) and dilated ducts >2× normal (39%). ‘Nuclear size’ was interpreted as nuclear area by 74% and nuclear diameter by 21%. Pure IDC-P in needle biopsies was reported by 100% and Gleason graded by 30%. All would perform immunohistochemistry in such cases to rule out invasive cancer. An IDC-P component associated with invasive cancer would be included in the determination of tumour extent and number of cores involved by 74% and 83%, respectively. 52% would include IDC-P component when grading invasive cancer. 48% would perform immunohistochemistry in solid or cribriform nests with comedonecrosis to exclude IDC-P (17% routinely, 30% if the focus appeared to have basal cells on H&E). 48% graded such foci as Gleason pattern 5 even if immunohistochemistry demonstrated the presence of basal cells.

Conclusions There is a need for more clarity in the definition of some of the diagnostic criteria for IDC-P as well as for greater standardisation of IDC-P reporting.


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