Qap (Anatomical Pathology) 

QAP Peer Review

AP105
Case History: M65 TURP for acute urinary retention
Intended diagnosis: Post-surgical granuloma. Contributed by:FML
Code Diagnosis Comment Score
anonymous Prostate - nodular hyperplasia and iatrogenic granuloma (100%) Please look for clinical history of recent transurethral resection.  100
anonymous Basal cell hyperplasia and focal granulomatous inflammation. 100% The granulomatous inflammation may represent previous needle biopsy tract or infection. Ziehl-Neelsen stain to exclude mycobacterial infection.  100
anonymous Post-TUR granuloma, in a background of nodular hyperplasia. 100% nil  100
anonymous PROSTATE, TURP : Iatrogenic granuloma after a surgical procedure in a prostate with nodular hyperplasia (100%) Also known as Post-transurethral resection granuloma. It is related to surgical procedures, e.g. transurethral resection of prostate, prostatic needle biopsy, etc. Usually the histology is characteristic and special stains for micro-organisms are not necessary. Only in rare cases, Ziehl-Neelsen stain is performed.  100
anonymous Benign prostatic hyperplasia with focal basal cell hyperplasia and granulomatous prostatits (100%) Seek a clinical history of a previous transurtheral resection i.e. (post-TUR granuloma) The following stains would be performed: Periodic-acid Schiff and Grocott's hexamine silver and Ziehl-Neelsen stains to exclude fungal and mycobacterial infections.  100
anonymous Palisading granuloma; consistent with effects of previous biopsy/TURP Perform ZN stain to exclude mycobacterial infection; Correlation with history of instrumentation.  100
anonymous Palisaded granuloma consistent with post-TUR granuloma. 100% Suggest correlate with clinical history of previous TUR.  100
anonymous Acute mucosal necrosis consistent with ischemic colitis. 100% Correlation with clinical and endoscopic findings is important.  100
anonymous granulomatous prostatitis Likely post instrumentation. Need to rule out TB  95
anonymous Post TURP/Bx palisading granulomas, no malignancy 100% TB is safely excluded by doing a Z-N stain.  100
anonymous Post-biopsy granuloma (100%) The morphologic features are that of granulomatous change post-biopsy, though ZN may be performed to exclude co-existing infective cause.  100
anonymous Necrotising granulomatous inflammation 100% DDx : infection & iatrogenic i.e. previous operation. Suggest special stains to exclude mycobacterial and fungal infection.  100
anonymous Transitional cell dysplasia - focal involving a few glands Prostatic basal cell hyperplasia Not sure with the small focus. Need deeper sections.  50
anonymous Granulomatous Prostatis 100% Special stains to exclude infections such as tubercolosis. Enquire about history of previous resection.  95
anonymous Granulomatous prostatitis, nodular hyperplasia with focal basal cell hyperplasia, no evidence of PIN changes or malignancy. 100% 1. It is prudent to exclude infection: ZN for TB, Grocott for fungus. 2. EVG stain should be done to study the relation of the granuloma to blood vessels (exclude the possibility of arteritis). 3. Has TURP been performed recently?  95
anonymous Fibromuscular and adenomatous hyperplasia; granulomatous prostatitis 100% Special stains must to done to exclude fungal or TB infection. The presence of eosinophils suggest that the granulomas may be iatrogenic (if a previous needle biopsy was done), or nonspecific.  95
anonymous Postsurgical granulomatous prostatitis. (100%) Nil  100
anonymous Nodular hyperplasia, basal cell hyperplasia and post-TUR granuloma nil  100
anonymous granulomatous prostatitis AND basal cell hyperplasia The changes are most consistent with instrumentation effect. We would like to do fungal and acid fast stains to rule out infections.  95