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

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Nodular_hyperplasia_of_the_prostate.jpg
| Width      =
| Caption    =
| Synonyms  = Nodular hyperplasia of the prostate gland. [[H&E stain]].
| Micro      = stromal and/or glandular hyperplasia
| Subtypes  =
| LMDDx      =
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = enlarged prostate gland, nodularity
| Grossing  =
| Site      = [[prostate gland]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = very common, esp. elderly
| Bloodwork  = +/-elevation of PSA (mild)
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        = medical, TURP
}}
'''Nodular hyperplasia of the prostate gland''', also '''benign prostatic hyperplasia''' (abbreviated '''BPH'''), is a common benign pathology of the [[prostate gland]].
'''Nodular hyperplasia of the prostate gland''', also '''benign prostatic hyperplasia''' (abbreviated '''BPH'''), is a common benign pathology of the [[prostate gland]].



Revision as of 16:21, 22 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.

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

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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.