Granulomatous prostatitis

Case contributed by Dr Yu-Ming Tang

Presentation

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

Patient Data

Age: 60
Gender: Male
MRI

Multiparametric MRI

Focal highly suspicious lesion in the left posterior and posterolateral PZ base.  Homogenous hypointense on T2WI. Broadbased 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 granulonomatous prostatitis and no carcinoma.

Granulomatous prostatitis is 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 tumour.  

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

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Case information

rID: 35665
Case created: 15th Apr 2015
Last edited: 10th Feb 2016
System: Urogenital
Inclusion in quiz mode: Included

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