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Benign prostate hyperplasia

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

PSA level 5. Digital rectal examination - benign feeling prostate. Malignancy?

Patient Data

Age: 75 years
Gender: Male
mri

Prostate volume 78 mL. PSA density of 0.11ng/mL.

Marked BPH (PIRADS 2).

The peripheral zones are normal. No significant PIRADS abnormality.

Normal seminal vesicles. No size significant pelvic lymphadenopathy. No focal bone lesion.

Right fat-containing inguinal hernia. Sigmoid diverticulosis.

Case Discussion

The prostate gland is markedly enlarged due to benign hyperplasia.  In a gland of this size, the PSA density is therefore low despite the marginally raised PSA level.

The normal appearances of the peripheral zones are well illustrated as well as the zonal anatomy of the prostate gland.

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