Granulomatous prostatitis

Case contributed by Yu-Ming Tang
Diagnosis almost certain

Presentation

History bladder tumor. Post surgery, BCG and interferon. PSA 5. Rule out prostate carcinoma.

Patient Data

Age: 60 years
Gender: Male

Multiparametric MRI

mri
This study is a stack
Axial
T2
This study is a stack
Sagittal
T2
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
Axial
Perfusion Map
Enhancement
graph
Download
Info

Focal highly suspicious lesion in the left posterior and posterolateral PZ base. Homogenous hypointense on T2WI. Broad-based capsular bulging raises the possibility of extracapsular invasion. Restricted diffusion with an ADC value of 550. Type 3 enhancement curve. Overall PIRADS score 5/5. 

Case Discussion

TRUS biopsy showed granulomatous prostatitis and no carcinoma.

Granulomatous prostatitis is a well described known mimicker of prostate carcinoma, clinically and on MRI.  Clinically it often presents with elevated PSA and a firm nodule on DRE. On MRI, the lesion demonstrates typical features of a highly suspicious neoplastic lesion.

Currently, histopathology is the only means of establishing the diagnosis and excluding a tumor.  

Possible causes include previous intravesical BCG treatment for bladder carcinoma, TB prostatitis, previous intervention (eg TURP) and idiopathic.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.