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Prostatitis Center |
Tucson, Arizona |
Cytology of Expressed Prostatic Secretions |
| J. Polacheck, E. Vega |
| Prostatitis Center and Carondelet St. Joseph's Hospital, Tucson, AZ |
| In order to learn more about the pathophysiology of "chronic" prostatitis, we
examined the cytology of expressed prostatic secretions (EPS). In the EPS from
most patients with chronic prostatitis, we have observed cohesive aggregates of
polymorphonuclear (PMN) leukocytes within a proteinaceous matrix. We call
these aggregates prostatic inflammatory aggregates (PIAs). PIAs are frequently
associated with corpora amylacea, concretions known to form inside the prostate. |
| We believe that PIAs may be pathognomonic for prostate inflammation because
we have observed, histopathologically, remarkably similar aggregates in prostate
tissue obtained surgically. These are normally ignored by surgical pathologists
when they are searching for cancer. |
| We find it remarkable that PIAs can be
expressed by massage. We have observed in the surgically obtained prostate
tissue that most PIAs are located in the periphery of the prostate gland. Prostatic
ducts are tortuous, branching, and very long relative to their narrow diameter. In
fact, prostatic ducts appear smaller in diameter than PIAs. Therefore, the ducts
must expand and/or the PIAs must deform in order for the PIAs to be expressed. |
Based on preliminary studies, we believe the following conclusions are likely:
- The inflammatory process is persistently active because the lifespan of
PMNs is known to be short, approximately 5 days.
- The inflammatory process is likely triggered by a bacteria or a bacteria-like organism because of the predominance of PMNs, not lymphocytes.
- PIAs in EPS may prove to be a specific clinical test of disease activity. We have already found it useful in the management of patients.
- Because PIAs are found in most prostates with BPH, a relationship
could exist between BPH and prostatitis.
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| Finally, we note the disparity between the clinical disease (chronic symptoms and
signs) and its pathology (an acute-inflammatory process). Perhaps this disorder,
therefore, should be called "chronic active prostatitis" (CAP). |
| Return to
1999 NIH abstracts |
Contacts
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- Mail
- 1701 W. St. Mary's Rd.
- Suite 102
- Tucson, Arizona 85754
- USA
- E-mail:
- jpolacheck@attglobal.net
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- Phone :
- 520-622-4599
- Answering Service:
- 520-570-6011
- Fax:
- 520-903-9972
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