Focal prostatic granulomas rheumatoid like--probably iatrogenic in origin

Small focal rheumatoid nodule-like granulomas have been noted in the prostatic chips from 11 repeat transurethral resections (TUR) in 10 patients. The lesions are situated in the prostatic stroma and are characterized by a central zone of fibrinoid necrosis, a peripheral palisade of fibroblasts and histiocytes and variable numbers of lymphocytes and giant cells. These granulomas are only noted in prostatic tissue from repeat TURs, are not evident in the original TUR tissue and probably have an iatrogenic basis. As yet, they appear to be of no clinical significance, but the entity is not well recognized, and the surgical pathologist should guard against over-interpretation of the lesions.