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• The prostate is located in front of the rectum and just below the
bladder (where urine is stored).
• BPH rarely causes symptoms before age 40, but more than half of
men in their sixties and as many as 90 percent in their seventies and
eighties have some symptoms of BPH
(prostate enlargement is as common a part of aging as gray hair)
Benign Prostate Hyperplasia
MORPHOLOGY…
Macroscopic features of BPH
• BPH arises most commonly in the inner, periurethral glands of the
prostate
• The nodules may have a solid appearance, or they may contain cystic
spaces (the latter corresponding to dilated glandular elements seen
in histologic sections)
• The urethra is usually compressed by the hyperplastic nodules
Normal prostate and benign prostatic hyperplasia (BPH).
- A normal prostate does not block the flow of urine from the bladder.
- An enlarged prostate presses on the bladder and urethra and blocks the flow of
urine.
Prostate hyperplasia
BPH
difficulty maintaining
Feeling need
a constant flow
to urinate frequently
of urine
SYMPTOMS
urinary tract
infections urgency to urinate
2. Prostate cancer
• current evidence indicates that there is no link between hypertrophy
prostate with cancer.
• The two conditions develop in different parts of the prostate:
– BPH occurs in the inner transition zone
– While cancer tends to develop in the peripheral outer zone.
The list of other complications :
enzim 5-alpha
Testosteron reductase type II DHT
Tahap lanjut :
• Nyeri pelvis
• Sering buang air kecil
• Nyeri saat buang air kecil
• Buang air kecil berdarah
• Nyeri saat ejakulasi
• Hilangnya nafsu makan dan BB
• Nyeri tulang
• Pembesaran KGB terutama pelvis
PATOLOGI
• Lesi dini massa berbatas tak
tegas tepat dibawah kapsul
prostat.
• Pada potongan permukaan,
fokus karsinoma tampak
sebagai lesi keras, berwarna
putih keabuan hingga kuning
yang berinfiltrasi ke kelenjar
terdekat dengan batas tak
jelas.
Mikroskopis
1. Invasi perineural
Indentasi perineural yang melibatkan
keseluruhan lingkar ruang perineural
Bukan hanya pada satu tepi dari saraf.
2. Mucinous fibroplasia (mikronodul kolagen)
Jaringan fibrous longgar /kolagen yang sangat
halus dengan pertumbuhan fibroblast ke dalam.
Kadang tampak seperti musin intraluminal.
3. Glomerulasi
Proliferasi kelenjar cribriform yang bukan
transluminal.
Formasi cribriform ini melekat hanya pada satu tepi
kelenjar menghasilkan struktur yang
menyerupai glomerulus.
Variasi gambaran histologis dari
kanker prostat :
Atrophic variant
Pseudohyperplastic variant
Foamy gland variant
Colloid & signet ring variant
Oncocytic variant
Lymphoepithelioma-like variant
Sarcomatoid variant (carcinosarcoma)
glom