Prostate
Microscopic mimics of prostatic carcinoma
Urothelial (transitional) metaplasia


Topic Completed: 1 February 2016

Revised: 27 February 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Urothelial metaplasia [title]

Andres Matoso, M.D.
Page views in 2018: 1,278
Page views in 2019 to date: 813
Cite this page: Matoso A. Urothelial metaplasia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/prostateurothelialmet.html. Accessed July 19th, 2019.
Definition / general
  • Urothelium lining the peripheral glands and ducts of the prostate
Essential features
  • The epithelium is composed of oval or spindle cells with occasional nuclear groves
  • The urothelial cells may be located underneath the prostatic luminal epithelium
  • Prostatic ducts may also show spread of urothelial carcinoma, but in contrast to urothelial metaplasia, it has high grade nuclear atypia, similar to CIS in the bladder
Epidemiology
  • Urothelial metaplasia can occur at any age
Sites
  • Peripheral prostate acini and ducts
Clinical features
  • Urothelial metaplasia is a histologic finding and has no clinical manifestations
Diagnosis
  • The diagnosis of urothelial metaplasia is morphologic
Treatment
  • Not required
Gross description
  • Urothelial metaplasia is not seen grossly
Microscopic (histologic) description
  • The epithelium is composed of oval or spindle cells with occasional nuclear groves
  • Focally, the cells may be oriented longitudinally to the basement membrane
  • The urothelial cells may be located underneath the prostatic luminal epithelium
Microscopic (histologic) images

Contributed by Andres Matoso, M.D.
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Urothelial metaplasia in a prostate needle biopsy

Positive stains
  • Stains positive for urothelial markers include p63, GATA3
Negative stains
  • Prostate makers: PSA, PSAP, NKX3.1
Differential diagnosis
  • The main differential diagnosis is with urothelial carcinoma spreading in prostatic ducts
    • In contrast to urothelial metaplasia, urothelial carcinoma is characterized by high grade nuclear atypia
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