After receiving the information that a BPEP was found on the biopsy specimen, immunostains for PSA and PAP (Figure 2, B) were performed on cytospin preparations from a 1-day-old urine sample.
Occasional intraluminal concretions and tiny basophilic granules were also seen, all diagnostic of a BPEP. A polypoid structure containing cuboidal epithelium consistent with a nephrogenic polyp and other areas with intestinal-type epithelium with presence of goblet cells and extracellular mucin consistent with cystitis glandularis were present in the bladder.
Benign prostatic epithelial polyps (BPEPs) have been described in the prostatic urethra, bladder, and ureteral orifice.[1-3] These lesions are most commonly found within the prostatic urethra, where they have been attributed to hyperplasia or evagination of the underlying prostatic ductal epithelium[1,3,4] or a metaplastic conversion of the overlying transitional epithelium. The histogenesis of BPEPs is controversial and may vary according to the location of the polyp. Most prostatic epithelial polyps of the urinary tract are benign.
Prostatic duct adenocarcinoma (PDA), originally believed to represent endometrial carcinoma derived from the prostatic utricle, may present as a papillary mass in the prostatic urethra and typically is associated with hematuria and/or obstructive symptoms, thus clinically mimicking BPEPs.[6-8] Like BPEPs, these tumors are often papillary and exophytic and are initially found in the prostatic urethra near the verumontanum.[6,7] The exophytic characteristic has been attributed in 1 case to the post-transurethral resection and evagination of prostatic epithelium. At least 1 reported case of PDA was thought to arise in preexisting BPEPs.