Flashcards in Prostate Pathology Deck (61)
What is the weight of a normal adult prostate?
Describe some general features of the prostate?
-Encircles the neck of the bladder and urethra
-Devoid of a distinct capsule
What are 4 biologic/anatomic distinct zones of the prostate?
1. Peripheral: Most carcinomas
3. Transitional: Most hyperplasia
4. Region of the anterior fibromuscular stroma
What 3 pathological processes can happen in the prostate?
2. Benign nodular enlargement (hyperplasia): This is most common and can be part of the normal aging process
What are the 2 forms of bacterial prostatitis?
Acute and chronic
What does acute bacterial prostatitis result from?
Bacterial similar to those that cause UTI
-Various strains of E. Coli
-Gram - Rods
What can acute bacterial prostatitis be secondary to?
Surgical manipulation of the urethra or prostate from catheterization, cystoscopy, urethral dilation, resection procedures on the prostate (these can all cause inflammation and become infected)
What is clinically assocaited with acute bacterial prostatitis?
Fever, chills, and dysuria
What is chronic bacterial prostatisis assocaited wtih?
A history of recurrent UTIs (cystitis and urethritis)
-This is difficult to diagnose and treat
What are the symptoms of chronic bacterial prostatitis?
Low back pain, dysuria, and perineal and suprapubic discomfort
How is chronic bacterial prostatitis diagnosed?
-Demonstration of leukocytosis (leukocytes and lymphocyres) in expressed prostatic secretions (massage the prostate) and positive bacterial culutes
What is the most common form of prostatitis?
Chronic abacterial prostatitis
Is chronic abacterial prostatitis clinically distinguishable from chronic bacterial prostatitis?
What is seen in chronic abacterial prostatitis?
1. No history of recurrent UTIs
2. Expressed prostatic secretions contain more than 10 leukocytes per high power field (inflammation of prostate)
3. Bacterial cultures are uniformly negative*** CULTURE SHOWS NOTHING
What is the most common cause of granulomatous prostatits related to?
Instillation of BCG with in the bladder
What is BCG?
AN attenuated mycobacterial strain
Why would you put BCG in a bladder?
It can help treat superficial bladder cancer
So, if you are putting a mycobacteria into the bladder, what will probably be seen in the bladder?
When do you see fungal granulomatous prostatitis?
Only in immunoscompromised hosts
What is nonspecific granulomatous prostatitis?
It represents a reaction to secretions from ruptured prostatic ducts and acini (secreting into surrrounding tissue)... this is relative common and no "solid" reason
What is the morphology of acute prostatitis?
-Minute, disseminated abscesses (small collection of neutrophils)
-Large, coalescent focal areas of necrosis
-Diffuse edema, congestion, and boggy suppuration of the entire gland
Why is biopsy of a man with acute prostatitis contraindicated?
Because it would HURT
and it can lead to sepsis when you drag the infection out
What is another name for benign prostatic hyperplasia?
Is BPH common?
Who does BPH affect?
Men over 50
What is BPH?
-Hyperplasia of prostatic stromal and epithelial cells
-Formation of large discrete nodules: Periurethral region of the prostate
-Large nodules compress and narrow the urethral canal: Partial, or sometimes virtually complete, obstruction of the urethra
What is the weight of the prostate in BPH?
Where does nodular hyperplasia originate?
In the inner aspect (transition zone)
*Remember, carcinoma is in the peripheral zone
What are early nodules composed of?