IPLab:Lab 2:Hyperplasia

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Contents

Clinical Summary

This 87-year-old man dated the onset of his illness to approximately six months prior to admission at which time he noted difficulty in starting his urine stream. He was seen several times in the emergency room for acute urinary retention"Urinary retention" is the inability to fully empty the bladder during urination. and dysuria"Dysuria" is the experience of pain upon urination.. On several occasions, significant numbers of white blood cells and bacteria (suggestive of acute cystitis"Cystitis" refers to an infection of the urinary bladder.) were noted in the patient's urine specimen.

Terminally, the patient developed fever, confusion that progressed to coma, convulsions, and shock. At the time of his death, the patient's major clinical problem was Gram-negative sepsisGram-negative sepsis is a systemic inflammatory response caused by the presence of Gram-negative bacteria and their endotoxins in the blood. The microbes usually enter the bloodstream from an area of localized infection. Gram-negative sepsis is the leading cause of septic shock--hence, also known as "endotoxic shock." Septic shock is a syndrome of inflammatory responses which can lead to severe hypotension, multiple organ system failure, and death. secondary to a urinary tract infection.

Autopsy Findings

At autopsy the prostate gland was grossly enlarged (6.5 x 4.8 x 3.2 cmThe dimensions of a normal prostate are 3.6 x 2.8 x 1.9 cm. So this prostate is enlarged.) and weighed 75 gramsNormally, a prostate in an 80 year old man should weigh about 40 grams.. The prostate gland was nodularNodular hyperplasia of the prostate--characterized by large discrete prostatic nodules--is a common disorder in men over 50 years of age. The nodules cause the prostate to be enlarged and to have an increased weight. The human prostate is surrounded by a restrictive capsule. These nodules cause increased pressure within the capsule which leads to constriction of the urethra as it passes through the prostate. Urethral constriction leads to retention of urine. but the nodules were confined within the prostatic capsuleProstate carcinomas spread through the capsule at an early stage, thus these nodules are more likely not to be cancer..

Images

Virtual Microscopy

Prostatic Hyperplasia

Normal Prostate

Study Questions


Additional Resources

Reference

Journal Articles

Images