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Prostate

Granulomatous lesions

Nonspecific granulomatous prostatitis


Reviewers: Ali Amin, M.D., (see Reviewers page)
Revised: 5 January 2012, last major update January 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Rare (< 1%) immune mediated reaction to prostatic secretions released from obstructed ducts
● Usually associated with nodular hyperplasia in men age 50+

Symptoms:
● Most commonly an incidental finding in Trucut biopsy for rising PSA
● 20% have triad of high fever, prostatitis symptoms and hard prostate on digital rectal examination

Gross description
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● Stone hard to firm
● Obliterated architecture
● Yellow nodules

Micro description
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● Granulomas surrounding destroyed prostatic glands or surrounding corpora amylacea
● Multinucleated giant cells (in 30% of cases)
● Epithelioid histiocytes
● Lymphocytes, plasma cells, fibrosis and eosinophils (may be prominent, Arch Pathol Lab Med 1997;121:724)
● No organisms, no caseation

Micro images
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Nonspecific granulomatous prostatitis

Positive stains
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● Histiocytes-lysozyme

Negative stains
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● Histiocytes-PSA/PAP (Am J Clin Pathol 1991;95:330)

Differential Diagnosis
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● Carcinoma: primary, metastatic
● Infection: acid-fast bacilli, fungi, etc.
● BCG therapy of bladder carcinoma, post TURP

End of Prostate > Granulomatous lesions > Nonspecific granulomatous prostatitis


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