Bladder - Prostatic-type polyps

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Bladder

Benign tumors

Prostatic-type polyps

Author: Nat Pernick, M.D. (see Authors page)

Reviewer: Tom Tong, M.D., Montefiore Medical Center North Division, Bronx, New York

Revised: 30 May 2010, last major update May 2010

Definition

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● Polyps similar to those in prostatic urethra

● Initially described in 1984 (Am J Surg Pathol 1984;8:833)

● See also ectopic prostate in Bladder chapter

Terminology

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● Adenomatous polyp or papillary adenoma with prostatic type epithelium

Epidemiology

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● Uncommon; mean age 46-50 years

Sites

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● Usually around bladder neck or ureteral orifices

Etiology

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● Most likely a type of metaplasia; may be due to injury

● Cases near ureteral orifices occur at younger age (mean 21 years), and may represent a developmental anomaly (Histopathology 1987;11:789)

Clinical features

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● Frequent cause of hematuria in young adults

Case reports

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● 35 year old man (Eur Radiol 2003;13 Suppl 6:L105)

● 58 year old man (Hinyokika Kiyo 1990;36:1463)

Treatment

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● Resection or biopsy and fulguration (Int Urol Nephrol 1997;29:313)

Gross description (Macroscopy)

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● Papillary or polypoid

Micro description (Histopathology)

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● Fibrovascular polyp lined by predominantly prostatic-type epithelium with foamy, faintly eosinophilic cytoplasm, with interspersed urothelium

● Cystitis glandularis often present

Micro images

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AFIP Fig 3-6: prostatic polyp of urethra

Cytology description

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● Clusters of benign columnar cells (Diagn Cytopathol 2003;29:356)

Positive stains

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● PSA, PAP

Differential Diagnosis

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● Ectopic prostate: no grossly noted polyp or fibrovascular core

● Polypoid cystitis: chronically inflamed bladder with grossly noted polypoid lesions (with edema) or papillary lesions; no prostate-type epithelium

End of Bladder > Benign tumors > Prostatic-type polyps

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