Atypical small acinar proliferation
Encyclopedia
In urologic pathology
, atypical small acinar
proliferation, abbreviated ASAP, is a collection of small prostatic gland
s, 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
, and analogous to the diagnosis of ASCUS
(atypical squamous cells of undetermined significance) on the Pap test.
, 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).
for re-biopsy; in one survey of urologists 98% of respondents considered it a sufficient reason to re-biopsy.
Pathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
, atypical small acinar
Acinus
An acinus refers to any cluster of cells that resembles a many-lobed "berry," such as a raspberry...
proliferation, abbreviated ASAP, is a collection of small prostatic gland
Gland
A gland is an organ in an animal's body that synthesizes a substance for release of substances such as hormones or breast milk, often into the bloodstream or into cavities inside the body or its outer surface .- Types :...
s, on prostate
Prostate
The prostate is a compound tubuloalveolar exocrine gland of the male reproductive system in most mammals....
biopsy
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
, whose significance is uncertain and cannot be determined to be benign
Benign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
or malignant.
ASAP, generally, is not considered a pre-malignancy, or a carcinoma in situ
Carcinoma in situ
Carcinoma in situ is an early form of cancer that is defined by the absence of invasion of tumor cells into the surrounding tissue, usually before penetration through the basement membrane. In other words, the neoplastic cells proliferate in their normal habitat, hence the name "in situ"...
; it is an expression of diagnostic uncertainty
Uncertainty
Uncertainty is a term used in subtly different ways in a number of fields, including physics, philosophy, statistics, economics, finance, insurance, psychology, sociology, engineering, and information science...
, and analogous to the diagnosis of ASCUS
Ascus
An ascus is the sexual spore-bearing cell produced in ascomycete fungi. On average, asci normally contain eight ascospores, produced by a meiotic cell division followed, in most species, by a mitotic cell division. However, asci in some genera or species can number one , two, four, or multiples...
(atypical squamous cells of undetermined significance) on the Pap test.
Association with adenocarcinoma
On a subsequent biopsyBiopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
, given the diagnosis of ASAP, the chance of finding prostate adenocarcinoma
Adenocarcinoma
Adenocarcinoma is a cancer of an epithelium that originates in glandular tissue. Epithelial tissue includes, but is not limited to, the surface layer of skin, glands and a variety of other tissue that lines the cavities and organs of the body. Epithelium can be derived embryologically from...
is approximately 40%; this is higher than if there is high-grade prostatic intraepithelial neoplasia
High-grade prostatic intraepithelial neoplasia
In urologic pathology, high-grade prostatic intraepithelial neoplasia, abbreviated HGPIN, is an abnormality of prostatic glands and believed to precede the development of prostate adenocarcinoma ....
(HGPIN).
Management
ASAP is considered an indicationIndication (medicine)
In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. The opposite of indication is contraindication.-Drugs:...
for re-biopsy; in one survey of urologists 98% of respondents considered it a sufficient reason to re-biopsy.