Granulomatous prostatitis

Last revised by Dr Jeremy Jones on 20 Sep 2021

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.

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

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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