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A man in his 60s presented with lower urinary tract symptoms. His serum prostate-specific antigen level was 6 ng/mL. A prostate biopsy was performed (figure 1).
What is your diagnosis?
High-grade prostatic intraepithelial neoplasia.
Intraductal carcinoma of prostate.
Prostatic intraepithelial neoplasia-like ductal carcinoma.
The correct answer is after the Discussion.
The prostate biopsy shows medium-sized prostate glands with papillary infoldings, tufting and prominent nucleoli (figure 2A–D). The low-power architecture with papillary infoldings is consistent with benign prostate glands. Tufting and nucleolar prominence would however suggest high-grade prostatic intraepithelial neoplasia (PIN).
Handling editor Iskander Chaudhry.
Contributors The case was identified by MV. The first draft of the manuscript was writtern by AEM. Both authors contributed to subsequent revisions.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.