Microscopic Evidence of Prostatic Stromal and Epithelial Hyperplasia: A Post- Mortem Study

Abstract

Background: The natural history of prostatic nodular hyperplasia (PNH) begins from the pathological phase. This may progress to the clinical phase. The clinical phase is a subset of macroscopic PNH, while the latter is a subset of pathological phase of PNH. The aim of this study is, therefore, to determine the pathological phase of PNH as a prelude to the clinical phase. Subjects and Methods: The prostate glands from adult males who died from nonprostate related cause at the University of Benin Teaching Hospital, Benin City were studied. Their glands were obtained during the autopsy, weighed, and the respective weight recorded. Sections were assessed for microscopic evidence of prostatic stromal and epithelial hyperplasia. The clinical case note of each male patient as well as the mortuary/autopsy register was consulted for details of the age and clinical diagnosis. Results: The population under study was 86 cases. Of these, 67 (77.9%) cases were in the pathological phase of PNH and their ages ranged from 31 to 78 years. Their mean age was 52.60 ± 12.02 years, while their median and modal ages were 53 and 50 years, respectively. The most common cause of death in these patients was accident/unnatural cause (24%). Nearly 49% (33 cases) had macroscopic PNH with a mean weight of 38.64 ± 8.59 g at a mean age of 59.64 ± 9.73 years. Fifty‑one percent (34 cases) had microscopic PNH. Their mean age and mean weight were 45.76 ± 9.97 years and 21.32 g ± 4.13, respectively. There was a significant increase in the mean weight of the prostate gland with age (p < 0.001). Cystic change (73%), chronic inflammation (51%), and acute inflammation (5%) in decreasing frequency were associated with the pathological phase of nodular hyperplasia. Conclusion: The natural history of nodular hyperplasia of the prostate is age‑dependent, whereas the actual pathogenesis is largely undetermined, although various postulates exist. Of these, chronic inflammation may play a role as observed in this study.