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Genitourinary
Diagnosis
Prostate
Prostatitis and Abscess
Prostatitis and Abscess
Bryan R. Foster, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • NIH classification
              • Type 1: Acute bacterial prostatitis
              • Type 2: Chronic bacterial prostatitis
              • Type 3: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
              • Type 4: Asymptomatic inflammatory prostatitis
            • Granulomatous prostatitis: Inflammatory process characterized by presence of granulomas

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Treatment

                                Selected References

                                1. Shakur A et al: Prostatitis: imaging appearances and diagnostic considerations. Clin Radiol. 76(6):416-26, 2021
                                2. Chatterjee A et al: Prostate MR: pitfalls and benign lesions. Abdom Radiol (NY). 45(7):2154-64, 2020
                                3. Green DB et al: Complications of intravesical BCG immunotherapy for bladder cancer. Radiographics. 39(1):80-94, 2019
                                4. Lee SM et al: Multiparametric MRI appearances of primary granulomatous prostatitis. Br J Radiol. 92(1098):20180075, 2019
                                5. Turkbey B et al: Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2. Eur Urol. 76(3):340-51, 2019
                                6. Ackerman AL et al: Diagnosis and treatment of patients with prostatic abscess in the post-antibiotic era. Int J Urol. 25(2):103-10, 2018
                                7. Diaz de Leon A et al: Case 258: granulomatous prostatitis. Radiology. 289(1):267-71, 2018
                                8. Jyoti R et al: In-gantry MRI guided prostate biopsy diagnosis of prostatitis and its relationship with PIRADS V.2 based score. J Med Imaging Radiat Oncol. 61(2):212-15, 2017
                                9. Rais-Bahrami S et al: Clinical and multiparametric MRI signatures of granulomatous prostatitis. Abdom Radiol (NY). 42(7):1956-62, 2017
                                10. Li Y et al: Beyond prostate adenocarcinoma: expanding the differential diagnosis in prostate pathologic conditions. Radiographics. 36(4):1055-75, 2016
                                11. Tommaso C et al: Prostatitis and Its Management Concepts and Recommendations for Clinical Practice. 1st Ed. Springer, 2016
                                12. Rosenkrantz AB et al: Radiologist, be aware: ten pitfalls that confound the interpretation of multiparametric prostate MRI. AJR Am J Roentgenol. 202(1):109-20, 2014
                                13. Hoeks CM et al: Diffusion-weighted magnetic resonance imaging in the prostate transition zone: histopathological validation using magnetic resonance-guided biopsy specimens. Invest Radiol. 48(10):693-701, 2013
                                14. Suzuki T et al: MRI findings of granulomatous prostatitis developing after intravesical Bacillus Calmette-Guérin therapy. Clin Radiol. 68(6):595-9, 2013
                                15. Murphy AB et al: Chronic prostatitis: management strategies. Drugs. 69(1):71-84, 2009
                                16. Rothman JR et al: Prostatitis: updates on diagnostic evaluation. Curr Urol Rep. 8(4):301-6, 2007
                                17. Habermacher GM et al: Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 57:195-206, 2006
                                18. Hua VN et al: Acute and chronic prostatitis. Med Clin North Am. 88(2):483-94, 2004
                                19. Shukla-Dave A et al: Chronic prostatitis: MR imaging and 1H MR spectroscopic imaging findings--initial observations. Radiology. 231(3):717-24, 2004
                                20. Gurunadha Rao Tunuguntla HS et al: Management of prostatitis. Prostate Cancer Prostatic Dis. 5(3):172-9, 2002
                                21. Engelhard K et al: Combination of signal intensity measurements of lesions in the peripheral zone of prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer. Eur Radiol. 10(12):1947-53, 2000
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Imaging

                                  • Top Differential Diagnoses

                                    • Pathology

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Definitions

                                          • NIH classification
                                            • Type 1: Acute bacterial prostatitis
                                            • Type 2: Chronic bacterial prostatitis
                                            • Type 3: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
                                            • Type 4: Asymptomatic inflammatory prostatitis
                                          • Granulomatous prostatitis: Inflammatory process characterized by presence of granulomas

                                        IMAGING

                                        • General Features

                                          • CT Findings

                                            • MR Findings

                                              • Ultrasonographic Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Treatment

                                                              Selected References

                                                              1. Shakur A et al: Prostatitis: imaging appearances and diagnostic considerations. Clin Radiol. 76(6):416-26, 2021
                                                              2. Chatterjee A et al: Prostate MR: pitfalls and benign lesions. Abdom Radiol (NY). 45(7):2154-64, 2020
                                                              3. Green DB et al: Complications of intravesical BCG immunotherapy for bladder cancer. Radiographics. 39(1):80-94, 2019
                                                              4. Lee SM et al: Multiparametric MRI appearances of primary granulomatous prostatitis. Br J Radiol. 92(1098):20180075, 2019
                                                              5. Turkbey B et al: Prostate imaging reporting and data system version 2.1: 2019 update of prostate imaging reporting and data system version 2. Eur Urol. 76(3):340-51, 2019
                                                              6. Ackerman AL et al: Diagnosis and treatment of patients with prostatic abscess in the post-antibiotic era. Int J Urol. 25(2):103-10, 2018
                                                              7. Diaz de Leon A et al: Case 258: granulomatous prostatitis. Radiology. 289(1):267-71, 2018
                                                              8. Jyoti R et al: In-gantry MRI guided prostate biopsy diagnosis of prostatitis and its relationship with PIRADS V.2 based score. J Med Imaging Radiat Oncol. 61(2):212-15, 2017
                                                              9. Rais-Bahrami S et al: Clinical and multiparametric MRI signatures of granulomatous prostatitis. Abdom Radiol (NY). 42(7):1956-62, 2017
                                                              10. Li Y et al: Beyond prostate adenocarcinoma: expanding the differential diagnosis in prostate pathologic conditions. Radiographics. 36(4):1055-75, 2016
                                                              11. Tommaso C et al: Prostatitis and Its Management Concepts and Recommendations for Clinical Practice. 1st Ed. Springer, 2016
                                                              12. Rosenkrantz AB et al: Radiologist, be aware: ten pitfalls that confound the interpretation of multiparametric prostate MRI. AJR Am J Roentgenol. 202(1):109-20, 2014
                                                              13. Hoeks CM et al: Diffusion-weighted magnetic resonance imaging in the prostate transition zone: histopathological validation using magnetic resonance-guided biopsy specimens. Invest Radiol. 48(10):693-701, 2013
                                                              14. Suzuki T et al: MRI findings of granulomatous prostatitis developing after intravesical Bacillus Calmette-Guérin therapy. Clin Radiol. 68(6):595-9, 2013
                                                              15. Murphy AB et al: Chronic prostatitis: management strategies. Drugs. 69(1):71-84, 2009
                                                              16. Rothman JR et al: Prostatitis: updates on diagnostic evaluation. Curr Urol Rep. 8(4):301-6, 2007
                                                              17. Habermacher GM et al: Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 57:195-206, 2006
                                                              18. Hua VN et al: Acute and chronic prostatitis. Med Clin North Am. 88(2):483-94, 2004
                                                              19. Shukla-Dave A et al: Chronic prostatitis: MR imaging and 1H MR spectroscopic imaging findings--initial observations. Radiology. 231(3):717-24, 2004
                                                              20. Gurunadha Rao Tunuguntla HS et al: Management of prostatitis. Prostate Cancer Prostatic Dis. 5(3):172-9, 2002
                                                              21. Engelhard K et al: Combination of signal intensity measurements of lesions in the peripheral zone of prostate with MRI and serum PSA level for differentiating benign disease from prostate cancer. Eur Radiol. 10(12):1947-53, 2000