Presentation
Fever since few days
Patient Data
Enlarged prostate measuring approx 60 x 62 x 83 mm (160 gms).
A large necrotic lesion measuring approx 23 x 53 x 44 mm is seen in the right peripheral zone mid gland, the apical region extending to the base. It is crossing midline to involve the left peripheral zone. It shows diffusion restriction. The lesion is indenting the rectum posteriorly.
Few T1 hyperintense nodules are seen in the transition zone on the left side, possibly representing calcifications.
The right seminal vesicle is enlarged and shows diffusion restriction.
The urinary bladder is partially distended. The enlarged median lobe of the prostate is indenting the bladder base.
Note is made of edema, inflammatory stranding in pelvic fat planes.
Irregular hyperintensities are seen in bilateral gluteal regions ,possibly related to IM injections.
Case Discussion
Findings are consistent with prostatitis with large prostatic abscess and right seminal vesiculitis. The abscess was incised, drained and the patient started on antibiotics.
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