Journal of Ultrasound in Medicine, Vol 9, Issue 12 677-680, Copyright © 1990 by American Institute of Ultrasound in Medicine
Transrectal ultrasound appearance of granulomatous prostatitis
R. Bude, R. L. Bree, R. S. Adler and S. Z. Jafri
Department of Radiology, University of Michigan Medical Center, Ann Arbor 48109.
Granulomatous prostatitis is an uncommon condition that can masquerade as
prostatic carcinoma on both digital rectal exam and prostate ultrasound. It
occurs most often after acute urinary tract infection, transurethral
prostate resection, or needle biopsy. It can be seen in systemic
granulomatous diseases and after intravesical bacillus Calmette-Guerin
(BCG) therapy for bladder carcinoma. In some cases it is idiopathic. Six
patients who underwent transrectal ultrasound of the prostate and
subsequent transrectal ultrasound-guided biopsy had histologic diagnosis of
granulomatous prostatitis. One patient was undergoing BCG therapy for
bladder cancer. Two patients had recent urinary tract infections. The other
three patients had no known predisposing conditions. Sonographically, the
glands were enlarged in five patients, with multiple large and small
hypoechoic zones throughout the peripheral, transition, and central zones.
The appearance was similar to that seen in diffuse prostatic carcinoma. In
one patient, a solitary hypoechoic lesion in the peripheral zone,
indistinguishable from carcinoma, was present. Granulomatous prostatitis
should be considered in the differential diagnosis of focal and diffuse
abnormality with prostatic ultrasound.
