Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
Arch Pathol Lab Med. 2012 Jul;136(7):721-34. doi: 10.5858/arpa.2011-0584-RA.
Specimens from the prostate and bladder are commonly encountered by the general surgical pathologist. Emphasis is usually placed on neoplasms of the bladder and prostate, particularly if malignant, owing to their therapeutic consequences. A good command of benign lesions occurring in the bladder and prostate, and knowledge of their preneoplastic potential will help pathologists confidently diagnose malignancy versus its benign mimickers and guide the urologists in choosing the appropriate therapy and follow-up for the patient.
To present a mixture of benign entities, and discuss their histologic and clinical characteristics, hoping to provide a practical review for the general surgical pathologist.
An extensive review of the literature on the entities discussed was performed.
A wide variety of benign entities are present in the prostate and bladder. Benign lesions in the prostate can be age related, such as prostatic atrophy and benign prostatic hyperplasia; transition zone associated, such as basal cell hyperplasia, adenosis, and sclerosing adenosis; or prostatic urethra associated. Benign lesions of the bladder encompass a wide variety of reactive changes that can occur in the urothelium, as well as hyperplastic lesions or reactive proliferations that could be misdiagnosed as malignant. The bladder responds to chronic irritation through several reactive/metaplastic lesions such as cystitis cystica/glandularis, keratinizing squamous metaplasia, or nephrogenic metaplasia. The urothelium can also give rise to hyperplastic/proliferative lesions, in particular von Brunn nest hyperplasia, papillary polypoid cystitis, and pseudocarcinomatous proliferation, which should be distinguished from malignant processes. Ectopic tissue, such as prostatic or mullerian, can also be seen.
前列腺和膀胱的标本通常由普通外科病理学家遇到。由于其治疗后果，通常强调膀胱和前列腺的肿瘤，特别是如果是恶性的。对发生在膀胱和前列腺中的良性病变有很好的掌握，并且了解其潜在的癌前病变，将有助于病理学家自信地诊断恶性肿瘤与其良性模拟物，并指导泌尿科医生为患者选择适当的治疗方法和随访。
介绍一系列良性实体，并讨论其组织学和临床特征，希望为普通外科病理学家提供实用的综述。
对所讨论实体的文献进行了广泛的回顾。
前列腺和膀胱中存在各种各样的良性实体。前列腺中的良性病变可能与年龄有关，如前列腺萎缩和良性前列腺增生；与移行区有关，如基底细胞增生、性腺病和硬化性腺病；或与前列腺尿道有关。膀胱的良性病变包括广泛的反应性变化，这些变化可能发生在尿路上皮中，以及增生性病变或反应性增殖，这些病变可能被误诊为恶性。膀胱通过几种反应性/化生病变对慢性刺激作出反应，如囊性膀胱炎/腺性膀胱炎、角化鳞状化生或肾源性化生。尿路上皮也会引起增生性/增殖性病变，特别是 von Brunn 巢增生、乳头状息肉状膀胱炎和假癌性增殖，应与恶性过程区分开来。也可以看到异位组织，如前列腺或米勒氏管组织。
