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patchology station/part 1/Benign Prostatic Hyperplasia

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دکتر حامد داداش کریمی متخصص اورولوژی

Date:
11/23/2018

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Catgory:
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Describtion

Benign Prostatic Hyperplasia

Most common urologic disease of men; incidence increase with age (50% in 50s and 80-90% in 70s and 80s).
Pathophysiology remains poorly understood; hormone alteration plays a central role – cellular accumulation of testosterone, particularly the active metabolite dihydrotestosterone (DHT).
Almost exclusively involves the area of transition zone (TZ).
Presents with lower urinary tract symptoms (LUTS).
Most common non-cancerous cause of serum PSA elevation.
Gross:
- Hallmark is nodular prostatic enlargement .
- Hyperplastic nodules are often multiple, mainly centered on proximal prostatic urethra involving submucosal compartment and TZ

Microscopic (histologic) description

Hyperplasia of glandular and stromal tissue with papillary buds, infoldings and cysts
Associated with squamous metaplasia and infarction
Begins around urethra where ejaculatory ducts enter prostate (transitional or periurethral zone)
Basal cell layer is continuous
Stromal changes are increased smooth muscle, lymphocytes and ducts (not associated with infectious process of prostatitis in most cases), reduced elastic tissue
Variations include sclerosing adenosis, fibroadenoma-like and phyllodes-like hyperplasia, leiomyoma-like nodules, fibromyxoid nodules; associated with infarct

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