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Granulomatous prostatitis

Dr Yair Glick ◉ and Dr Behnam Shayegi et al.

Granulomatous prostatitis is a nodular form of chronic prostatitis. It is usually diagnosed on biopsy.

On this page:

Article:

Pathology
Radiographic features
History and etymology
Related articles
References

Pathology

Causes

idiopathic
infection
iatrogenic
- BCG
- post-radiotherapy
systemic disease:
- sarcoidosis
- autoimmune

Subtypes

Several classification systems exist. A frequently used classification specifies the following subtypes:

non-specific granulomatous prostatitis (NSGP): considered one of the commonest subtypes ^4,5
infectious
indeterminate

An alternate classification system has also been described:

non-specific granulomatous prostatitis
tubercular granulomatous prostatitis
postsurgical granulomatous prostatitis
allergic granulomatous prostatitis
xanthogranulomatous prostatitis

Histology

Histological appearances are related to the underlying subtype ⁷.

Radiographic features

General features

Often there is no definite imaging finding to allow the diagnosis of granulomatous prostatitis to be made or, indeed, to differentiate it from prostatic carcinoma ².

Widening of the prostatic urethra, however, may be a useful feature in differentiation from cancer ¹.

Ultrasound

Ultrasound findings are divided into a hypoechoic nodule (~70%) or a diffusely hypoechoic peripheral zone (~30%)

MRI

Three morphological MRI patterns have been described which are diffuse, nodular (tumor-like), and cystic with mural nodule ³.

Signal characteristics include

T2: affected regions hypointense
C+ (Gd): no enhancement following Gd-DTPA

History and etymology

It was first described by F H Tanner and J R McDonald in 1943 ¹³.

References

1. Ney C, Miller HL, Levy JL. Granulomatous prostatitis. Special reference to radiologic findings. Urology. 1983;21 (3): 320-3. Pubmed citation
2. Naik KS, Carey BM. The transrectal ultrasound and MRI appearances of granulomatous prostatitis and its differentiation from carcinoma. Clin Radiol. 1999;54 (3): 173-5. Pubmed citation
3. Suzuki T, Takeuchi M, Naiki T et-al. MRI findings of granulomatous prostatitis developing after intravesical Bacillus Calmette-Guérin therapy. Clin Radiol. 2013;68 (6): 595-9. doi:10.1016/j.crad.2012.12.005 - Pubmed citation
4. Murugan P, Brown RE, Zhao B. Nonspecific granulomatous prostatitis with prostatic adenocarcinoma. Indian journal of pathology & microbiology. 53 (1): 152-4. doi:10.4103/0377-4929.59211 - Pubmed
5. Pavlica P, Barozzi L, Bartolone A, Gaudiano C, Menchi M, Veneziano S. Nonspecific granulomatous prostatitis. Ultraschall in der Medizin (Stuttgart, Germany : 1980). 26 (3): 203-8. doi:10.1055/s-2005-858072 - Pubmed
6. Kumbar R, Dravid N, Nikumbh D, Patil A, Nagappa KG. Clinicopathological Overview of Granulomatous Prostatitis: An Appraisal. Journal of clinical and diagnostic research : JCDR. 10 (1): EC20-3. doi:10.7860/JCDR/2016/15365.7146 - Pubmed
7. Bour L, Schull A, Delongchamps NB, Beuvon F, Muradyan N, Legmann P, Cornud F. Multiparametric MRI features of granulomatous prostatitis and tubercular prostate abscess. Diagnostic and interventional imaging. 94 (1): 84-90. doi:10.1016/j.diii.2012.09.001 - Pubmed
8. Rifkin MD, Tessler FN, Tublin ME, Ross JS. US case of the day. Granulomatous prostatitis resulting from BCG therapy. Radiographics : a review publication of the Radiological Society of North America, Inc. 18 (6): 1605-7. doi:10.1148/radiographics.18.6.9821203 - Pubmed
9. Clements R, Thomas KG, Griffiths GJ, Peeling WB. Transrectal ultrasound appearances of granulomatous prostatitis. Clinical radiology. 47 (3): 174-6. Pubmed
10 .Bavelloni A, Piazzi M, Raffini M, Faenza I, Blalock WL. Prohibitin 2: At a communications crossroads. IUBMB life. 67 (4): 239-54. doi:10.1002/iub.1366 - Pubmed
11. Shukla P, Gulwani HV, Kaur S. Granulomatous prostatitis: clinical and histomorphologic survey of the disease in a tertiary care hospital. Prostate international. 5 (1): 29-34. doi:10.1016/j.prnil.2017.01.003 - Pubmed
12. Mohan H, Bal A, Punia RP, Bawa AS. Granulomatous prostatitis--an infrequent diagnosis. International journal of urology : official journal of the Japanese Urological Association. 12 (5): 474-8. doi:10.1111/j.1442-2042.2005.01068.x - Pubmed
13. F.H. Tanner, J.R. McDonald Granulomatous prostatitis: a histologic study of a group of granulomatous lesions collected from prostate glands Arch Pathol Lab Med, 36 (1943), pp. 358-370

Prostate pathology

prostate gland
- prostate tumors
  - prostate adenocarcinoma
    - prostate biopsy
    - imaging in prostate adenocarcinoma
    - prostate adenocarcinoma staging
      - Gleason score
      - PI-RADS
  - prostate sarcoma
- infections of the prostate
  - prostatitis
    - acute bacterial prostatitis
    - chronic prostatitis
      - chronic bacterial prostatitis
      - chronic prostatitis and chronic pelvic pain syndrome (CPPS)
    - asymptomatic inflammatory prostatitis
    - granulomatous prostatitis
      - prostatic tuberculosis
    - emphysematous prostatitis
  - prostatic abscess
- benign prostatic hypertrophy
- cystic lesions of the prostate
  - prostatic utricle cyst
  - prostatic cystadenoma
- prostatic calcification
- prostatic infarction

Article information

rID: 24640

System: Urogenital

Tag: refs, cases

Synonyms or Alternate Spellings:

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