Granulomatous prostatitis is a nodular form of chronic prostatitis. It is usually diagnised by biopsy.
- iatrogenic: (BCG,post radiation)
- systemic disease such as
- autoimmune diseases
Often there is no definite ultrasound or MRI finding that allows a specific diagnosis of granulomatous prostatitis to be made, or differentiation from prostatic carcinoma 2.
Widening of the prostatic urethra however may be a useful feature in differentiation from prostatic carcinoma 1.
May be seen as a hypoechoic nodule (~70%) or diffuse hypoechoic peripheral zone (~30%)
Three morphological MRI patterns have been described which are diffuse (most common), nodular, and cystic with mural nodule 3.
Signal characterisitcs include
- T2 - hypointense
- C+ (Gd) - no enhancement following Gd-DTPA
- prostate tumours
- infections of the prostate
- benign prostatic hypertrophy
- cystic lesions of the prostate
- prostate cancer
- 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