Inflammatory Conditions III

Postbiopsy Granlomas: 

• After 9 days to 52 months of transurethral resection.
• Although its much more common to have granulomatous rxn following TUR similar linear granulomas may rarely develop following a needle bx. 
• Postbiopsy granulomas are composed of central region of fibrinoid necrosis surrounded by palisading epithelioid histiocytes.
• In contrast to infectious granulomas, the necrosis in postbiopsy granulomas often contains ghost lıke structures of  vessels, acini and stroma.
• Wedge shaped granulomas , irregularity of their shapes (granulomas) distinguishes these granulomas from  infectious granulomas.
• Postbiopsy granulomasalso  rarelyoccur following a needle bx.
• The postbiopsy granulomas appears to be a rxn to altered epithelium and stroma from the trauma of previous cautery.

• Posrbiopsy granulomas are asymptomatic, incidental findings requiring no treatment.

Systemic Granulomatous Prostatitis:   

• Cases with eosinophilia such as allergic granulomatous prostatitis - Church Strauss ,without eosinophlia- Wegener
• Histopathology; multiple, small , ovoid, granulomas surrounded by numerous eosinophils.
• Regularity of size and shape of these granulomas, the eosinophilic necrosis within the granulomas and extensive infiltration of eosinophils throughout stroma, not just surrounding the granulomas , seperate this entitiy from that of postbiopsy ranulomas with eosinophils.

 *Source: Biopsy Interpretation of the Prostate -Jonathan I. Epstein