Thinking Beyond Adenocarcinoma of Prostate: A Case Series of T2W Hyperintense Prostatic Lesions

Abstract

The T2-weighted sequences form an integral part of multiparametric Magnetic Resonance Imaging (MRI) protocol performed for evaluation of the prostate. Most commonly encountered prostatic pathologies are adenocarcinoma and benign prostatic hyperplasia, which are mostly T2W hypointense and heterogeneously hypointense, respectively. Apart from prostatic cysts, only a small proportion of prostatic lesions demonstrate predominantly high signal intensity on T2-weighted sequences. Herein, the authors present three such cases with T2W hyperintense prostatic lesions. The first case (60-year-old male) was a prostatic abscess, which apart from T2W hyperintensity, showed central restricted diffusion and peripheral enhancement. The second case (40-year-old male) was a cystic lesion in left side of prostate, which was an ectopic ureterocele opening into the prostatic urethra with associated left renal agenesis. The third case (35-year-old male) was of a metastatic prostatic malignancy, which was a rare prostatic sarcoma. Radiologists should be cognizant of such conditions so as to enable them to make accurate diagnosis and guide appropriate patient management.