Granulomatous prostatitis - an infrequent diagnosis

Background: Granulomatous prostatitis is an unusual benign inflammatory process of the prostate. Clinically, it mimics prostatic carcinoma, thus requiring pathological examination for diagnosis. Materials and methods: Histopathological records of 1353 prostate specimens received in the Department of Pathology, Government Medical College, Chandigarh, India, over a period of 8 years (1995-2002) were reviewed and 20 cases of granulomatous prostatitis were retrieved. Results: Out of 20 cases of granulomatous prostatitis, we encountered 12 cases of non-specific granulomatous prostatitis, two cases of xanthogranulomatous prostatitis, two cases of tuberculous prostatitis, two cases of malakoplakia prostate and one case each of granulomatous prostatitis associated with adenocarcinoma prostate and post-surgical palisading granuloma. The diagnosis was made by histopathological examination of Trucut biopsy, transuretheral resection of prostate chips or retropubic prostatectomy specimen. In all the cases, granulomatous prostatitis was an incidental finding. Conclusions: Non-specific granulomatous prostatitis is the most common type of granulomatous prostatitis. Despite tuberculosis being very common in India, granulomatous prostatitis associated with tuberculosis is not common. Distinction between non-specific and infectious granulomatous prostatitis is important for therapeutic reasons.