Periacinar retraction artifact of the prostate

Abstract

Retraction artifacts are well known phenomenon in diagnostic surgical pathology for a long time but they were usually considered as artificially produced tissue alteration. Some recent studies of retraction artifact in different tumors have focused on its diagnostic and/or prognostic role. Their presence in prostatic carcinoma may be used in diagnostic and prognostic purposes. Peritumoral retraction artefacts in prostatic carcinoma are more pronounced and more common around neoplastic glands compared to benign glands, gland with prostatic intraepithelial neoplasia and postatrophic hyperplasia that is the one of the most common mimickers of prostatic carcinoma. In addition, the presence of extensive retraction artifact in prostatic carcinomas is clearly associated with tumor features that indicate a more aggressive tumor phenotype and with shorter biochemical recurrence-free survival. Studies at the molecular level demonstrate that retraction artifact may be attributed to molecules produced by reactive cancer stroma. The origin of retraction artifact in tumor specimens is unknown but they are probably the consequence of lack of basal cells and /or stromal changes but not simply artifacts due to laboratory procedures.

Peritumoral Clefting and Expression of MMP-2 and MMP-9 in Basal Cell Carcinoma of the Skin

“…BCC is microscopically characterized by nests of basaloid cells showing peripheral palisading, surrounded by peritumoral empty spaces that are usually regarded as artifacts due to fixation of specimens. However, there are other suggestions regarding the cause of peritumoral clefting (5,6,18). Acs et al suggested that retraction clefting represents prelymphatic spaces in cases of breast carcinoma (8).…”

“…Peritumoral clefts (retraction clefting) are empty spaces arround tumor nests that may be seen in different tumor types (5)(6)(7)(8). The exact mechanism of their evolution is still controversial, although the loss of basal epithelial cells, the lower expression of adhesion molecules and the higher expression of proteins involved in extracellular matrix remodeling most probably have a major role.…”

Prognostic Significance of Lymphatic Vessel Density Detected by D2-40 and Its Relation to Claudin-4 Expression in Prostatic Adenocarcinoma

“…Previously, it was considered merely a laboratory procedure artifact, but lately, there have been some assumptions that peritumoral retractions actually might represent lymphatic spaces. 7 D2-40 (podoplanin antigen) is expressed in lymphatic endothelial cells without reacting with the endothelium of blood capillaries, arteries, or veins in normal and neoplastic tissues, hence allowing lymphatic vessels (LVs) identification and assessment of their density. 8 Therefore, immunohistochemical detection of D2-40 antibody is useful to differentiate actual lymph vessels and lymphatic invasion from periacinar retractions.…”

Periacinar Retraction Clefting and D2-40 Expression in Prostatic Adenocarcinoma

“…The neoplastic cells of prostatic cancer often appear pulled away from the surrounding stroma, leaving empty spaces that completely or partially encircle the acini; these are called retraction clefts or retraction artifacts and were described for the first time in 1960s in autopsy studies by Halpert and co-workers [1,2]. Periacinar retraction clefts in prostatic carcinoma serve as a helpful additional criterion in setting of pathohistological diagnosis, particularly in differentiating it from some benign conditions (atrophy, postatrophic hyperplasia, atypical adenomatous hyperplasia), which may mimic prostatic carcinoma [3][4][5][6][7][8]. They are mostly seen in Gleason grade 3, occasionally appear in grades 2 and 4 but are uncommon in comedo type…”