Diagnostic Ultrasound - Abdomen and Pelvis

Enlarged Prostate
Benign Prostatic Hyperplasia
Benign Prostatic Hyperplasia
(Left) Axial NECT shows a
markedly enlarged prostate,
which is homogeneous with
well-defined margins. (Right)
Sagittal CT in the same
patient shows mildly
heterogeneous enhancement
of the markedly enlarged TZ
. Associated severe bladder
wall trabeculation ſt is
consistent with bladder outlet
obstruction. Presence of a
large jackstone within the
bladder indicates bladder
decompensation.
Differential Diagnoses: Prostate
Benign Prostatic Hyperplasia
Prostatic Adenocarcinoma
(Left) Transverse transrectal
ultrasound (TRUS) shows
heterogeneous enlargement
of both lobes of the TZ . The
peripheral zone is severely
compressed st. Hypoechoic
line represents the
pseudocapsule . (Right)
Transverse TRUS at the level
of the apex shows a slightly
hypoechoic mass causing
asymmetric, nodular
enlargement of the left 1/2 of
the prostate . Targeted MR-
US fusion biopsy of this mass
revealed Gleason 4+5 prostate
adenocarcinoma.
Prostatic Adenocarcinoma
Other Primary Prostatic Tumors: Benign
and Malignant
(Left) Large, centrally necrotic
pelvic mass encases the
rectum and calcified vas
deferens st. Pathology from
TRUS-guided biopsy showed
Gleason 5+5 adenocarcinoma.
(Right) Centrally necrotic,
enhancing pelvic mass
arising from the prostate
anteriorly displaces the
bladder ſt. The rectum is
separate. Surgical pathology
from surgical resection
revealed prostate sarcoma,
not otherwise specified.
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