Difference between revisions of "Prostate gland"

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Prostate gland (view source)

Revision as of 20:47, 29 June 2013

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→‎Granulomatous prostatitis: split-out
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==Granulomatous prostatitis==
==Granulomatous prostatitis==
*[[AKA]] ''prostatic granuloma''.
{{Main|Granulomatous prostatitis}}
*[[AKA]] ''prostate gland granuloma''.
===General===
*Common.
*Usually secondary to BCG treatment of [[urinary bladder cancer|bladder cancer]].
*Several classifications exist<ref name=pmid17092284>{{Cite journal  | last1 = Uzoh | first1 = CC. | last2 = Uff | first2 = JS. | last3 = Okeke | first3 = AA. | title = Granulomatous prostatitis. | journal = BJU Int | volume = 99 | issue = 3 | pages = 510-2 | month = Mar | year = 2007 | doi = 10.1111/j.1464-410X.2006.06585.x | PMID = 17092284 | URL = http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2006.06585.x/full }}</ref> - the most commonly used is by ''Epstein & Hutchins''.
 
====Epstein & Hutchins classification====
The groupings:<ref name=pmid6432674>{{Cite journal  | last1 = Epstein | first1 = JI. | last2 = Hutchins | first2 = GM. | title = Granulomatous prostatitis: distinction among allergic, nonspecific, and post-transurethral resection lesions. | journal = Hum Pathol | volume = 15 | issue = 9 | pages = 818-25 | month = Sep | year = 1984 | doi =  | PMID = 6432674 }}</ref>
#Non-specific.
#*No cause identified, usu. incidentally discovered.
#*Most common.
#Post-[[TURP]].
#*Palisading [[granuloma]] with necrotic core (histology similar to a [[rheumatoid nodule]]<ref name=pmid6703198>{{Cite journal  | last1 = Mies | first1 = C. | last2 = Balogh | first2 = K. | last3 = Stadecker | first3 = M. | title = Palisading prostate granulomas following surgery. | journal = Am J Surg Pathol | volume = 8 | issue = 3 | pages = 217-21 | month = Mar | year = 1984 | doi =  | PMID = 6703198 }}</ref><ref>URL: [http://www.humpath.com/spip.php?article18010 http://www.humpath.com/spip.php?article18010]. Accessed on: 26 September 2012.</ref>) +/- eosinophils.
#Specific.
#*Identifiable infectious agent, usu. BCG (in the context of treating bladder cancer), rarely [[tuberculosis]] and even more rarely various [[fungi]] and [[syphilis]].
#Allergic granulomatous prostatitis.
#*Usually associated with eosinophils.
#*Examples:
#*#[[Wegener granulomatosis]].
#*#[[Churg-Strauss syndrome]].
 
===Microscopic===
Features:
*[[Granulomas]] in the prostate - '''key feature'''.
**Palisading granulomas with a necrotic core (similar to a [[rheumatoid nodule]]) consistent a prior TURP.<ref name=pmid6703198/>
*+/-Eosinophils.
 
====Images====
<gallery>
Image:Granulomatous_inflammation_of_bladder_neck.jpg | Granulomatous inflammation of the prostate/bladder neck - low mag. (WC/Nephron)
Image:Granulomatous_inflammation_of_bladder_neck_high_mag.jpg | Granulomatous inflammation of the prostate/bladder neck - high mag. (WC/Nephron)
</gallery>
===Stains===
*[[GMS stain]].
*[[Ziehl-Neelsen stain]].
 
Note:
*Stains are indicated when there is a suspicion of an infective etiology based on histomorphology or clinical information (e.g. immunosuppression).
 
===Sign out===
====Post-TURP====
<pre>
PROSTATE GLAND, TRANSURETHRAL RESECTION OF THE PROSTATE (TURP):
- BENIGN PROSTATIC TISSUE WITH GLANDULAR AND STROMAL PROLIFERATION.
- PALISADING GRANULOMA WITH NECROTIC CORE, SEE COMMENT.
 
COMMENT:
This is morphologically consistent with a post-TURP granuloma.
</pre>
 
====Idiopathic====
<pre>
A-L. PROSTATE GLAND,
RIGHT LATERAL SUPERIOR, RIGHT MEDIAL SUPERIOR, RIGHT LATERAL MIDZONE,
RIGHT MEDIAL MIDZONE, RIGHT LATERAL INTERIOR, RIGHT MEDIAL INFERIOR,
LEFT LATERAL SUPERIOR, LEFT MEDIAL SUPERIOR, LEFT LATERAL MIDZONE,
LEFT MEDIAL MIDZONE, LEFT LATERAL INTERIOR, LEFT MEDIAL INFERIOR,
  CORE BIOPSIES:
- BENIGN PROSTATE TISSUE;
- GRANULOMATOUS PROSTATITIS, NON-NECROTIZING, SEE COMMENT.
 
COMMENT:
Granulomatous prostatitis is usually idiopathic. Other possibilities include:
post-procedural granulomatous inflammation (e.g. post-TURP, BCG treatment),
allergic prostatitis and infections.
 
Infectious etiologies of granulomatous disease should be considered clinically.
</pre>


==Atrophy of the prostate==
==Atrophy of the prostate==
Michael
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