Granulomatous prostatitis

Last revised by Mostafa El-Feky on 14 Jul 2023

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

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

An alternate classification system has also been described:

  • non-specific granulomatous prostatitis

  • tubercular granulomatous prostatitis - prostatic tuberculosis

  • postsurgical granulomatous prostatitis

  • allergic granulomatous prostatitis

  • xanthogranulomatous prostatitis

Histological appearances are related to the underlying subtype 7.

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. The diagnosis should always be made histologically.

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

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

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

Patient should be followed up till complete resolution of imaging changes to ensure a prostate cancer has not been masked.

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

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Cases and figures

  • Case 1
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