Presentation
Repeated episodes of fever. Suspected prostatic abscess on clinical examination and USG.
Patient Data
Diffuse heterogeneous signal intensity is seen involving peripheral as well as transitional zones. A necrotic appearing lesion measuring approx 19 x 21 x 17 mm (AP x TD x CC) is seen in the right peripheral zone mid-gland / apical region showing diffusion restriction and peripheral enhancement on post-contrast study. The lesion is mildly bulging at the prostatic capsule and indenting the rectum posteromedially.
A similar lesion measuring approx 15 x 18 x 19 mm (AP x TD x CC) is seen in right transitional zone midland/base region.
Multiple other smaller foci of diffusion restriction are seen in the bilateral peripheral and transitional zones.
Bilateral seminal vesicles appear heterogeneous ,possibly related to seminal vesiculitis.
Significant fat stranding is seen in peripancreatic fat planes.
Hypertrophied median lobe of prostate is indenting the bladder base.
Urinary bladder is partially distended.
Few small, non-specific bilateral iliac lymph nodes are seen (RightL>eft).
Case Discussion
Findings are consistent with prostatitis with multiple abscesses. Abscess in the right peripheral zone mid-gland / apical region was incised, drained and the patient started on antibiotics.
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