The central portions of the prostatic ducts are normally lined by urothelium. When urothelial lining is seen in more peripheral ducts and glands as in this needle biopsy, the term urothelial metaplasia is used.
Note the lack of cytologic atypia which is helpful in distinguishing urothelial metaplasia from high-grade PIN.
In this transurethral resection, clusters of mucinous glands lined by tall columnar cells are seen admixed with usual prostatic glands. The mucin is positive for mucicarmine, PAS, and alcian blue. The glands are negative for PSA and PAP.
The nuclei are small and basally located and lack prominent nucleoli. The differential diagnosis is with Cowper’s glands and adenocarcinoma.
Mucinous metaplasia in a needle biopsy of the prostate. Note partial involvement in one of the glands on the right.
Mucinous glands are negative for PSA immunostain. Same case as previous slide.
Squamous metaplasia in prostate can be seen in response to infarction, inflammation, radiation therapy, or androgen deprivation therapy
Squamous metaplasia adjacent to an area of infarction in a transurethral resection specimen
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