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Prostate

Benign lesions/conditions

Infarct


Reviewers: Komal Arora, M.D., (see Reviewers page)
Revised: 14 April 2012, last major update April 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● 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
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● Variable size
● Speckled, gray-yellow, with streaks of blood and sharp peripheral margins

Micro description
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● 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

Micro images
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Squamous metaplasia adjacent to infarct

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

End of Prostate > Benign lesions/conditions > Infarct


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