Background: Nodular hyperplasia (NH), also known as benign prostatic hyperplasia, is the most common benign prostatic lesion affecting aging men. Despite its high prevalence and impact on quality of life, comprehensive histopathological data on NH patterns in Nigerian populations remain limited.

Objective: To characterize the histomorphologic patterns, age distribution, associated lesions, and temporal trends of nodular hyperplasia in prostatic specimens at Jos University Teaching Hospital (JUTH) from 2000-2009.

Methods: Retrospective analysis of 1,450 prostatic specimens. All NH cases were analyzed for histological patterns (glandulostromal vs. stromal), associated lesions, age distribution, and temporal trends using standard H&E staining and WHO classification.

Results: NH accounted for 1,029 of 1,450 specimens (70.9%), representing the most common prostatic pathology. Mean age was 67.8 years with peak incidence in the 60-69 years group (35.6%). Glandulostromal pattern predominated (87.9%, n=905), while stromal pattern occurred in 12.1% (n=124). Isolated NH comprised 77.3% (n=795), with chronic prostatitis the most common associated finding (21.9%, n=225). Acute prostatitis (0.3%) and squamous metaplasia (0.6%) were rare. Annual cases ranged from 31-170 (mean 102.9/year).

Conclusion: NH is the predominant prostatic pathology in North Central Nigeria (70.9%). Peak occurrence in the 7th decade, predominance of glandulostromal pattern (87.9%), and frequent chronic prostatitis association (21.9%) have important clinical implications. These findings emphasize NH as a major contributor to male morbidity requiring sustained clinical attention.