Morphologic and clinical spectrum of large gland lesions of the prostate

Large gland lesions of the prostate encompass a spectrum of entities from benign histoanatomic variation to invasive high-grade carcinoma. Despite overlapping morphologic features, accurate diagnosis is critical because the clinical management of these lesions varies from no additional follow-up to possible definitive resection or radiotherapy. This manuscript provides a concise overview of large gland lesions with a focus on practical diagnostic features and clinical significance. Where necessary, a brief historical perspective is included as many of these entities have diagnostic and molecular criteria which are still being established. Unfortunately, controversies and lack of consensus within urologic subspecialty groups have made this a challenging topic for the broader pathologist community. This paper serves as a snapshot of our current understanding of the spectrum of intraductal lesions of the prostate and their mimics.