Differential diagnosis of uncommon prostate diseases: combining mpMRI and clinical information

Abstract

The differential diagnosis of abnormalities in the prostate is broad, covering common (acinar adenocarcinoma, benign prostatic hyperplasia, chronic prostatitis, hemorrhage, cysts, calcifications, atrophy and fibrosis) and less common conditions (tumors other than acinar adenocarcinoma, granulomatous prostatitis containing tuberculosis, abscesses and other conditions, and idiopathic disorders such as amyloidosis and exophytic benign prostatic hyperplasia). Recent advances in magnetic resonance imaging (MRI) of the prostate gland and imaging guidelines, such as the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1), have dramatically improved the ability to distinguish common abnormalities, especially the ability to detect clinically significant prostate cancer (csPCa). Overlap can exist in the clinical history and imaging features associated with various common/uncommon prostate abnormalities, and biopsy is often required but is invasive. Prostate abnormalities can be divided into two categories: category 1, diseases for which PI-RADS scores are suitable for use, and category 2, diseases for which PI-RADS scores are unsuitable for use. Radiologists must have an intimate knowledge of other diseases, especially uncommon conditions. Past relevant history, symptoms, age, serum prostate-specific antigen (PSA) levels, MRI manifestations, and the applicability of the PI-RADS assessment should be considered when diagnosing prostate abnormalities.

Administration of Caesalpinia bonduc Seed Extracts Ameliorates Testosterone-Induced Benign Prostatic Hyperplasia (BPH) in Male Wistar Rats

“…PSA is a glycoprotein that is produced by the secretory epithelium of the prostate gland and it has been reported to be mildly increased in BPH. 46 PSA level will significantly increase in both benign and malignant lesions of the prostate but is usually marked in case of prostatic cancer. 47 , 48 Thus, the enhanced serum PSA levels of the disease control group suggest the development of BPH for this group of rats and a decrease in PSA is linked to a reduction in prostatic hyperplasia due to inhibition of prostatic 5α-reductase, the enzyme that converts DHT.…”

A preliminary study on the diagnostic value of PSADR, DPC and TSRP in the distinction of prostatitis and prostate cancer

“…Imaging observations showed that most of the prostate cancer was convex, while most of the prostate inflammatory diseases were capsular atrophy and gland collapse. Prostate cancer is mostly unilateral lesions with focal nodular low signal, clear boundary and mass effect, which often leads to destruction of the prostate capsule [ 14 , 15 ]. We calculated the oval area as its "ideal prostate area" by measuring the transverse and longitudinal diameters of the prostate, and calculated the DPC compared to its true area.…”

Prostate malignant tumor and benign prostatic hyperplasia microenvironments in black African men: Limited infiltration of CD8+ T lymphocytes, NK‐cells, and high frequency of CD73+ stromal cells

“…Benign prostatic hyperplasia (BPH), a pathology for which lower urinary tract symptoms are common manifestations, affects more than half of men above 65 years old 1 . Although Prostate cancer occurs independently of benign prostatic hyperplasia, there might be some overlapping in symptoms, biomarker expression, or secretion 5 . Prostate cancers are most often detected based on elevated blood levels of prostate‐specific antigen, a glycoprotein (PSA > 4 ng/mL) generally expressed by prostate tissue, 3 and nonspecific lower urinary tract symptoms 6 .…”

“…Prostate cancers are most often detected based on elevated blood levels of prostate‐specific antigen, a glycoprotein (PSA > 4 ng/mL) generally expressed by prostate tissue, 3 and nonspecific lower urinary tract symptoms 6 . Also, common prostate diseases, including BPH, and prostatitis, have varying degrees of elevated blood PSA levels and nonspecific lower urinary tract symptoms (LUTS) 5,6 . Therefore, a tissue biopsy is a gold standard for confirming prostate cancer and defining the tumor microenvironment.…”