Prostatic Intraepithelial neoplasia (PIN)

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*1965 and 1969 John McNeal (Cancer)
* 1986 J McNeal & Bostwick: Intraductal dysplasia: three grades
Prostatic intraepithelial neoplasia (PIN).
They fused grades 2 and 3 to form high grade PIN and grade 1 PIN was considered low grade.


 {Diagram of carcinogenesis in the human prostate. According to the disease continuum concept. Grade 1 PIN corresponds to very mild-mild dysplasia, Grade 2 to moderate dysplasia, and Grade 3 to severe dysplasia-carcinoma in situ. The precusor stage ends when malignant cells invade the stroma; this invasion occurs where the basal cell layer is disrupted and the basement membrane is fragmented. Notice that the dysplastic changes occur in the superficial (lumenal secretory phase).}

 * Crowding of  cells
* Nuclear variation in size
* Small nucleoli; but some large nucleoli may be present
* Normal chromatin
* No mitosis

 Prostatic intraepithelial neoplasia (Dysplasia grade 2)
* Cellular stratification
* Nuclear enlargment
* Increased hyperchromasia
* Some cells with enlarged nucleolus
* Cytoplasmic eosinophilia 
* No mitosis

 High Grade PIN
* Cellular stratification
* Nuclear enlargment
* Large prominent nucleoli
* May show bridging and/or papillary formation
*Chromatin margination
* Retention of the basal cell layer
* Rare or no mitosis

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