Related Experiment Video
Updated: Jul 8, 2026
Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
Published on: May 9, 2018
Iatrogenic pulse granuloma detected at prostatectomy
Roy Nambudripad1, Navneet Narula, Mark Li-cheng Wu
1Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Irvine, California.
Abstract:
Pulse granulomas are peculiar reactions to vegetable matter characterized by aggregates of hyaline rings and may be oral or extraoral. Pulse granulomas are important to recognize because they may indicate serious pathologic processes, may simulate neoplasia clinically, and may morphologically be confused with hyaline vasculopathy. We recently encountered a case involving a highly unusual pulse granuloma in a 55-year-old man who underwent prostatectomy for adenocarcinoma. Prior pancolonoscopy and digital rectal examination excluded significant colorectal disease. Microscopy showed a prominent pulse granuloma with demonstrable vegetable matter occupying periprostatic soft tissue. Interestingly, retrospective review of material from prior prostatic core biopsies revealed vegetable matter that appeared identical to the vegetable matter in the pulse granuloma. We conclude that the biopsies transrectally displaced vegetable matter, which provided the nidus for the pulse granuloma. We present the first pulse granuloma to be caused by a biopsy or to occupy periprostatic soft tissue.
Insights
This study describes a rare pulse granuloma caused by vegetable matter displaced during a transrectal prostate biopsy. This finding highlights a novel etiology for this peculiar pathological reaction.
Area of Science:
- Pathology
- Urology
Background:
- Pulse granulomas are reactive lesions to vegetable matter, presenting as hyaline rings, and can occur orally or extraorally.
- Recognizing pulse granulomas is crucial due to their potential to mimic neoplasia and resemble hyaline vasculopathy.
Observation:
- A unique case of pulse granuloma in the periprostatic soft tissue of a 55-year-old man post-prostatectomy for adenocarcinoma was identified.
- Microscopic examination revealed vegetable matter within the granuloma, consistent with prior transrectal prostatic core biopsies.
Findings:
- Vegetable matter from transrectal biopsies was identified as the likely nidus for the development of the periprostatic pulse granuloma.
- This represents the first documented instance of a pulse granuloma attributed to a biopsy procedure and located in the periprostatic region.
Implications:
- This case expands the known causes and locations of pulse granulomas.
- It underscores the importance of considering iatrogenic factors, such as biopsy-induced displacement of foreign material, in the differential diagnosis of granulomatous inflammation.