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

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*Post-void dribbling.
*Post-void dribbling.
*Prolonged voiding.
*Prolonged voiding.
Others:
*Hematuria - common.<ref name=pmid24364522>{{Cite journal  | last1 = Sharp | first1 = VJ. | last2 = Barnes | first2 = KT. | last3 = Erickson | first3 = BA. | title = Assessment of asymptomatic microscopic hematuria in adults. | journal = Am Fam Physician | volume = 88 | issue = 11 | pages = 747-54 | month = Dec | year = 2013 | doi =  | PMID = 24364522 }}</ref>


Treatment:
Treatment:

Revision as of 01:21, 23 February 2014

Nodular hyperplasia of the prostate gland
Diagnosis in short
Synonyms Nodular hyperplasia of the prostate gland. H&E stain.
LM stromal and/or glandular hyperplasia
Gross enlarged prostate gland, nodularity
Site prostate gland
Prevalence very common, esp. elderly
Blood work +/-elevation of PSA (mild)
Prognosis benign
Treatment medical, TURP

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.

Others:

  • Hematuria - common.[2]

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.
  2. ↑ Sharp, VJ.; Barnes, KT.; Erickson, BA. (Dec 2013). "Assessment of asymptomatic microscopic hematuria in adults.". Am Fam Physician 88 (11): 747-54. PMID 24364522.
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