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Atypical small acinar proliferation

Atypical small acinar proliferation
Classification and external resources
eMedicine med/3056
NCI Atypical small acinar proliferation
Patient UK Atypical small acinar proliferation

In urologic pathology, atypical small acinar proliferation, abbreviated ASAP, is a collection of small prostatic glands, 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,[1] and analogous to the diagnosis of ASCUS (atypical squamous cells of undetermined significance) on the Pap test.

Association with adenocarcinoma

On a subsequent biopsy, 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).[2]


ASAP is considered an indication for re-biopsy;[3] in one survey of urologists[4] 98% of respondents considered it a sufficient reason to re-biopsy.

See also


  1. Flury SC, Galgano MT, Mills SE, Smolkin ME, Theodorescu D (January 2007). "Atypical small acinar proliferation: biopsy artefact or distinct pathological entity". BJU International 99 (4): 780–5. PMID 17378841. doi:10.1111/j.1464-410X.2006.06703.x. 
  2. Leite KR, Camara-Lopes LH, Cury J, Dall'oglio MF, Sañudo A, Srougi M (June 2008). "Prostate cancer detection at rebiopsy after an initial benign diagnosis: results using sextant extended prostate biopsy". Clinics 63 (3): 339–42. PMC 2664245. PMID 18568243. doi:10.1590/S1807-59322008000300009. 
  3. Bostwick DG, Meiers I (July 2006). "Atypical small acinar proliferation in the prostate: clinical significance in 2006". Arch. Pathol. Lab. Med. 130 (7): 952–7. PMID 16831049. doi:10.1043/1543-2165(2006)130[952:ASAPIT]2.0.CO;2. 
  4. Rubin MA, Bismar TA, Curtis S, Montie JE (July 2004). "Prostate needle biopsy reporting: how are the surgical members of the Society of Urologic Oncology using pathology reports to guide treatment of prostate cancer patients?". Am. J. Surg. Pathol. 28 (7): 946–52. PMID 15223967. doi:10.1097/00000478-200407000-00016.