Difference between revisions of "Nodular hyperplasia of the prostate gland"

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#redirect [[Prostate gland#Prostatic nodular hyperplasia]]
'''Nodular hyperplasia of the prostate gland''', also '''benign prostatic hyperplasia''' (abbreviated '''BPH'''), is a common benign pathology of the [[prostate gland]].
 
It is also known as '''prostatic nodular hyperplasia'''. Occasionally, it is referred to as
'''benign prostatic hypertrophy'''; this is a misnomer. This pathology is ''not'' a hypertrophy.
 
==General==
*Very common.
*Incidence increases with age.
 
Clinical - mnemonic ''I WISH 2p'':<ref>{{Ref TN2006| U5}}</ref>
*Intermittency.
*Weak stream.
*Incomplete emptying.
*Straining.
*Hesitancy.
*Post-void dribbling.
*Prolonged voiding.
 
Treatment:
*Medications.
*Transurethral resection of the prostate (TURP).
 
==Gross==
*Enlargement of the prostate.
*Nodularity of the prostate.
 
==Microscopic==
Features:
*Stromal and/or glandular hyperplasia.
 
Note:
*Should '''not''' be diagnosed on core biopsy!
 
DDx:
*[[Urothelial carcinoma]] - significant nuclear atypia.
 
===Images===
<gallery>
Image:Nodular_hyperplasia_of_the_prostate.jpg | Prostatic nodular hyperplasia. (WC/Nephron)
</gallery>
 
==Sign out==
===Urothelium present===
<pre>
PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP):
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION.
- UROTHELIAL MUCOSA WITH A MILD LYMPHOCYTIC INFILTRATE.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
<pre>
PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) AND URINARY BLADDER NECK:
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION.
- UROTHELIUM WITH THE CHANGES OF CYSTITIS CYSTICA ET GLANDULARIS.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
<pre>
PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) AND URINARY BLADDER NECK:
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION, AND FOCAL
  ACUTE AND CHRONIC INFLAMMATION.
- UROTHELIUM WITH THE CHANGES OF CYSTITIS CYSTICA ET GLANDULARIS.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
===No urothelium present===
<pre>
PROSTATE GLAND, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP):
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION.
</pre>
 
===Post-TURP granuloma present===
<pre>
PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP):
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION WITH
PROMINENT BLOOD VESSELS AND SQUAMOUS METAPLASIA.
- PALISADING GRANULOMA WITH NECROTIC CORE, SEE COMMENT.
- UROTHELIAL MUCOSA WITH A MILD INFLAMMATORY INFILTRATE.
- NEGATIVE FOR MALIGNANCY.
 
COMMENT:
This is morphologically consistent with a post-TURP granuloma.
</pre>
 
==See also==
*[[Prostate gland]].
 
==References==
{{Reflist|2}}
 
[[Category:Prostate gland]]
[[Category:Diagnosis]]

Revision as of 16:16, 22 February 2014

Nodular hyperplasia of the prostate gland, also benign prostatic hyperplasia (abbreviated BPH), is a common benign pathology of the prostate gland.

It is also known as prostatic nodular hyperplasia. Occasionally, it is referred to as benign prostatic hypertrophy; this is a misnomer. This pathology is not a hypertrophy.

General

  • Very common.
  • Incidence increases with age.

Clinical - mnemonic I WISH 2p:[1]

  • Intermittency.
  • Weak stream.
  • Incomplete emptying.
  • Straining.
  • Hesitancy.
  • Post-void dribbling.
  • Prolonged voiding.

Treatment:

  • Medications.
  • Transurethral resection of the prostate (TURP).

Gross

  • Enlargement of the prostate.
  • Nodularity of the prostate.

Microscopic

Features:

  • Stromal and/or glandular hyperplasia.

Note:

  • Should not be diagnosed on core biopsy!

DDx:

Images

  • Prostatic nodular hyperplasia. (WC/Nephron)

Sign out

Urothelium present

PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP):
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION.
- UROTHELIAL MUCOSA WITH A MILD LYMPHOCYTIC INFILTRATE.
- NEGATIVE FOR MALIGNANCY.

PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) AND URINARY BLADDER NECK:
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION.
- UROTHELIUM WITH THE CHANGES OF CYSTITIS CYSTICA ET GLANDULARIS.
- NEGATIVE FOR MALIGNANCY.

PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP) AND URINARY BLADDER NECK:
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION, AND FOCAL 
  ACUTE AND CHRONIC INFLAMMATION.
- UROTHELIUM WITH THE CHANGES OF CYSTITIS CYSTICA ET GLANDULARIS.
- NEGATIVE FOR MALIGNANCY.

No urothelium present

PROSTATE GLAND, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP):
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION.

Post-TURP granuloma present

PROSTATE TISSUE, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP):
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION WITH 
PROMINENT BLOOD VESSELS AND SQUAMOUS METAPLASIA.
- PALISADING GRANULOMA WITH NECROTIC CORE, SEE COMMENT.
- UROTHELIAL MUCOSA WITH A MILD INFLAMMATORY INFILTRATE.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
This is morphologically consistent with a post-TURP granuloma.

See also

References

  1. ↑ Shiau, Carolyn; Toren, Andrew (2006). Toronto Notes 2006: Comprehensive Medical Reference (Review for MCCQE 1 and USMLE Step 2) (22nd edition (2006) ed.). Toronto Notes for Medical Students, Inc.. pp. U5. ISBN 978-0968592861.
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