Granulomatous prostatitis
Granulomatous prostatitis is a nodular form of chronic prostatitis. It is usually diagnosed on biopsy.
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Pathology
Causes
- idiopathic
- infection
- iatrogenic
- Bacillus Calmette–Guérin (BCG) vaccine
- 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.
Related Radiopaedia articles
Prostate pathology
-
prostate gland
- prostate tumors
- 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
- emphysematous prostatitis
- prostatic abscess
-
prostatitis
- benign prostatic hypertrophy
- cystic lesions of the prostate
- prostatic calcification
- prostatic infarction