Nodular hyperplasia of the prostate gland

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:

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

Others:

• Hematuria - common.

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

• 

  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

• Prostate gland.