Benign Conditions That Mimic Prostate Carcinoma: MR Imaging Features with Histopathologic Correlation
- 1 January 2016
- journal article
- research article
- Published by Radiological Society of North America (RSNA) in RadioGraphics
- Vol. 36 (1), 162-175
- https://doi.org/10.1148/rg.2016150030
Abstract
Multiparametric magnetic resonance (MR) imaging combines anatomic and functional imaging techniques for evaluating the prostate and is increasingly being used in diagnosis and management of prostate cancer. A wide spectrum of anatomic and pathologic processes in the prostate may masquerade as prostate cancer, complicating the imaging interpretation. The histopathologic and imaging findings of these potential mimics are reviewed. These entities include the anterior fibromuscular stroma, surgical capsule, central zone, periprostatic vein, periprostatic lymph nodes, benign prostatic hyperplasia (BPH), atrophy, necrosis, calcification, hemorrhage, and prostatitis. An understanding of the prostate zonal anatomy is helpful in distinguishing the anatomic entities from prostate cancer. The anterior fibromuscular stroma, surgical capsule, and central zone are characteristic anatomic features of the prostate with associated low T2 signal intensity due to dense fibromuscular tissue or complex crowded glandular tissue. BPH, atrophy, necrosis, calcification, and hemorrhage all have characteristic features with one or more individual multiparametric MR imaging modalities. Prostatitis constitutes a heterogeneous group of infective and inflammatory conditions including acute and chronic bacterial prostatitis, infective and noninfective granulomatous prostatitis, and malacoplakia. These entities are associated with variable clinical manifestations and are characterized by the histologic hallmark of marked inflammatory cellular infiltration. In some cases, these entities are indistinguishable from prostate cancer at multiparametric MR imaging and may even exhibit extraprostatic extension and lymphadenopathy, mimicking locally advanced prostate cancer. It is important for the radiologists interpreting prostate MR images to be aware of these pitfalls for accurate interpretation. Online supplemental material is available for this article. ©RSNA, 2015This publication has 61 references indexed in Scilit:
- Value of the Hemorrhage Exclusion Sign on T1-weighted Prostate MR Images for the Detection of Prostate CancerRadiology, 2012
- Normal Central Zone of the Prostate and Central Zone Involvement by Prostate Cancer: Clinical and MR Imaging ImplicationsRadiology, 2012
- ESUR prostate MR guidelines 2012European Radiology, 2012
- Is Apparent Diffusion Coefficient Associated with Clinical Risk Scores for Prostate Cancers that Are Visible on 3-T MR Images?Radiology, 2011
- Prostate cancer vs. post-biopsy hemorrhage: Diagnosis with T2- and diffusion-weighted imagingJournal of Magnetic Resonance Imaging, 2010
- Multi-parametric MR imaging of transition zone prostate cancer: Imaging features, detection and stagingWorld Journal of Radiology, 2010
- Tuberculosis of the prostate and urethra: A reviewIndian Journal of Urology, 2008
- Sarcoidosis of the prostateJournal of Clinical Pathology, 2006
- Granulomatous prostatitis – an infrequent diagnosisInternational Journal of Urology, 2005
- MALAKOPLAKIAJournal of Urology, 2005