The prostate is a gland that manufactures a milky fluid that is an important component of the semen. The prostatic fluid functions as a nutrient and vehicle for sperm. Like any gland in the body, the prostate has acini, the part that manufactures prostatic fluid, and the ducts, the tiny tubes through which the fluid is released at the time of ejaculation.
High-grade prostate intra-epithelial neoplasia (HGPIN) refers to abnormal cells lining the prostate acini and ducts. The abnormal cells, atypical or malignant-appearing, are confined to the superficial layer of cells. This condition is not prostate cancer, in which malignant cells extend beyond the superficial cell layer into the deeper layer of cells of the acini and ducts. This diagnosis is provided by the pathologist by a careful microscopic examination of the prostate biopsy specimens.
The incidence of HGPIN on biopsy is between 5-8%. 25% of men diagnosed with HGPIN are ultimately diagnosed with prostate cancer. Thus HGPIN may be considered a pre-malignant condition that mandates careful follow-up. The recommended follow-up is a repeat prostate ultrasound and biopsy one year after the HGPIN is diagnosed.
Andrew Siegel, M.D.
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