Non-specific granulomatous prostatitis and xanthogranulomatous prostatitis are likely caused by a blockage of prostatic ducts
and stasis of gland secretions.
Spread of adenocarcinoma within prostatic ducts
The pathogens track back up the urethra and can spread in the prostatic ducts
Prostatitis, a lower urinary tract infection, occurs by retrograde entry of organisms into the prostatic ducts
via urethra from oral, anal, genital intercourse or masturbating practices, by hematogenous spread from other foci, or lymphatic extension from infected kidneys.
10] Typically, entry of microorganisms occurs via the urethra into the prostatic ducts
due to direct migration or with intraprostatic reflux of urine.
7) The most common form of granulomatous prostatitis consists of "nonspecific granulomatous prostatitis" and is characterized by granulomatous inflammation arranged concentrically around prostatic ducts
or glands (Figure 1), and can be accompanied by giant cells and a mixture of inflammatory cells including eosinophils.
Although in earlier literature, (3) the term intraductal carcinoma of the prostate has been used variably to describe the extension of prostatic acinar carcinoma, prostatic ductal carcinoma, and urothelial carcinoma into prostatic ducts
and acini, currently IDC-P refers to a lumen-spanning proliferation of malignant cells within prostatic ducts
and acini caused by the spread of prostate cancer cells within preexisting prostatic glandular structures.
3] Originally, ductal carcinoma of the prostate was thought to have arisen from the prostatic utricle in the form of a mullerian ductal structure; however, immunohistochemistry studies have since shown that this rare form of prostate cancer arises from the prostatic ducts
pTis pd: Carcinoma in situ, involvement of prostatic ducts
The two main techniques are (1) removal of the prostatic adenoma using the technique of a Millen simple retropubic prostatectomy, excising the adenoma tissue containing the prostatic ducts
and most acini, leaving the surgical capsule and seminal vesicles intact,[sup.
The problem with granulomatous prostatitis is that the sheets of epithelioid (or foamy) macrophages, as well as scattered epithelial cells from remnants of ruptured prostatic ducts
and acini, may all be confused with high-grade (Gleason grade 5) adenocarcinoma.
Guo and Epstein (30) published morphologic criteria in prostate biopsy specimens that define IDC-P as malignant epithelial cells filling large acini and prostatic ducts
, with at least partial preservation of basal cells forming either (1) solid or dense cribriform patterns or (2) loose cribriform or micropapillary patterns with either marked nuclear atypia (nuclear size 6X normal or larger) or comedonecrosis.