Focal prostatic granulomas rheumatoid like--probably iatrogenic in origin.

Area of Science:

• Uropathology
• Surgical Pathology
• Rheumatology

Background:

• Rheumatoid nodule-like granulomas are uncommon findings in prostate tissue.
• Their occurrence is specifically linked to repeat transurethral resections (TUR).

Purpose of the Study:

• To describe the histological features of these granulomas.
• To investigate their association with repeat TUR procedures.
• To clarify their clinical significance and implications for surgical pathologists.

Main Methods:

• Histopathological examination of prostatic chips from repeat transurethral resections (TUR).
• Comparison with initial TUR tissue samples.
• Analysis of lesion characteristics including necrosis, cellular infiltrate, and giant cells.

Main Results:

• Small, focal rheumatoid nodule-like granulomas were identified in prostatic chips from 11 repeat TURs in 10 patients.
• Lesions exhibited central fibrinoid necrosis, a palisade of fibroblasts and histiocytes, lymphocytes, and giant cells.
• Granulomas were absent in original TUR tissue, suggesting an iatrogenic origin.
• The identified lesions were deemed to have no current clinical significance.

Conclusions:

• Rheumatoid nodule-like granulomas in prostate tissue are likely iatrogenic, associated with repeat transurethral resections (TUR).
• These findings appear to be of no clinical significance.
• Surgical pathologists should be aware of this entity to avoid over-interpretation.