Benign lesions / conditions

Topic Completed: 1 April 2012

Revised: 26 February 2019

Copyright: 2003-2019,, Inc.

PubMed search: prostatic infarct

Komal Arora, M.D.
Page views in 2018: 1,280
Page views in 2019 to date: 1,089
Cite this page: Arora K. Infarct. website. Accessed September 17th, 2019.
Definition / general
  • Mean age 71 years (Am J Surg Pathol 2000;24:1378)
  • Usually associated with nodular hyperplasia in TURP specimens, not needle biopsies
  • Usually clinically silent, may cause acute urinary retention due to associated edema
  • May cause gross hematuria if adjacent to urethra
  • May cause marked PSA elevation that returns to normal after removal of infracted tissue
  • Causes: trauma, catheter, cystitis, prostatitis
Gross description
  • Variable size
  • Speckled, gray-yellow, with streaks of blood and sharp peripheral margins
Microscopic (histologic) description
  • Ischemic type infarcts with sharply outlined areas of coagulative necrosis of glands and stroma
  • May see prominent squamous metaplasia with mitotic figures at the periphery of the infarct (but no keratinization, no pleomorphism, localized to area of infarct only)
  • Cyst formation often present within glands, corpora amylacea and collagenous rings present around metaplastic glands
  • Zonation is present, but may not be appreciated by needle biopsy
Microscopic (histologic) images

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Squamous metaplasia adjacent to infarct

Differential diagnosis
  • Necrosis from infectious granulomas, post-biopsy granulomas (fibrinoid necrosis surrounded by pallisading epithelioid histiocytes), squamous and urothelial carcinoma
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