Ectopic prostate tissue at the ureteral orifice of the bladder:a clinicopathological analysis and review of literature

CHEN Ying; ZHU Gui-xiang; LIU Jing-jing; LIU Min; HUANG Wen-tao; ZHOU Heng-hua

doi:10.3969/j.issn.1007-8096.2023.08.006

Abstract：Objective To investigate the clinicopathological features of ectopic prostate tissue(EPT)at the ureteral orifice of the bladder and avoid misdiagnosis.Methods The clinicopathologic data of 2 patients with EPT at the ureteral orifice of the bladder were retrospectively analyzed,and the pathologic features and differential diagnosis points were summarized combined with the relevant literature review.Results Both of 2 patients were male,aged 43 and 60 years old respectively.The former sought medical attention because of bloody sperm,and the latter was found to have a bladder mass during a physical examination.Ureteroscopy and cystoscopy showed that the lesions were located at the ureteral orifice of the bladder,which were follicular and polypoid-protuberance lesions respectively.Subsequently biopsy was performed.Macroscopic examination showed grey-white small tissues with a diameter of 0.1-0.2 cm.Under low power microscope,the polypoid-shaped lesion was covered with normal urothelium,and very different glandular cavities were scattered randomly in the mucosa lamina propria.Under medium and high power microscope,the gland cavity showed a mild double-layer cell structure,consisting of cubic/columnar secretory cells in the inner layer and basal-like cells in the outer layer,accompanied by clusters/papillary hyperplasia in some areas.All of the cells had no obvious atypia and mitotic figures.Amyloid bodies could be seen in some gland cavities.Immunohistochemical analysis revealed that the glands stained diffusely and strongly positive for PSA and PSAP within the luminal epithelial cells,while negative for P504S,PAX-8,CK7 and CK20.Basal-like cells showed positive expression of CK5/6,P63 and GATA-3,highlighting an outer basal layer associated with all of the glands.The Ki-67 index was approximately 1％.Conclusion The EPT at the ureteral orifice of the bladder is very rare clinically,which belongs toa benign disease with good prognosis after complete excision.However,it is easily misdiagnosed as bladder malignant tumor before operation.