Case of the Week

2019-44 / DECEMBER 23 (CONTRIBUTOR: ANKUR SANGOI )

76 y/o M, presents with hematuria. On cystoscopy, bladder lesion found and biopsied.

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Quiz

1. What is the correct diagnosis?

a. prostatic ductal adenocarcinoma

b. papillary urothelial neoplasm

c. prostatic-type polyp

d. nephrogenic adenoma

e. papillary/polypoid cystitis

Prostatic-type polyps have also been described in the literature as "ectopic prostatic tissue." They consist of papillary/polypoid epithelial proliferations composed of prostatic-type secretory glandular cells (positive for prostatic markers) surrounded by basal cells. In addition, urothelial cells may be seen admixed within them giving the impression of a second cell population.
The typical clinical presentation for these lesions is hematuria. The age of presentation is wide. The most common site of occurrence is the prostatic urethra followed by the urinary bladder (usually the trigone, as in this case). Recognizing these lesions as benign is crucial, with prostatic ductal adenocarcinoma the most important misdiagnoses to avoid (lack 2-cell population; usually more cellular with complex architecture, prominent nucleoli, and atypia).

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The Genitourinary Pathology Society (GUPS) was formed with the vision of advancing the care of patients with urologic diseases through enhancements of best practices, research, and education in the subspecialty of Urological Pathology.

GUPS is an official Companion Society of the United States and Canadian Academy of Pathology (USCAP).

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