Korean J Radiol.  2001 Sep;2(3):159-163. 10.3348/kjr.2001.2.3.159.

Hypoechoic Rim of Chronically Inflamed Prostate, as Seen at TRUS: Histopathologic Findings

• Lee HJ
• Choe GY
• Seong CG
• Kim SH

• KMID: 754101
• DOI: http://doi.org/10.3348/kjr.2001.2.3.159

Abstract

OBJECTIVE
The purpose of this study is to correlate the findings of peripheral hypoechoic rim, seen at transrectal ultrasonography (TRUS) in chronic prostatitis patients, with the histopthologic findings. MATERIALS AND METHODS: Seven patients with pathologically proven chronic prostatitis were involved in this study. The conspicuity of the peripheral hypoechoic prostatic rim, seen at TRUS, was prominent and subtle, and to determine its histopathologic nature, the microscopic findings were reviewed. RESULTS: In five of seven cases (71%), TRUS demonstrated a prominent peripheral hypoechoic rim. Microscopic examination revealed that inflammatory cell infiltration of prostatic glandular tissue was severe in three cases (42.9%), moderate in two (28.6%), and minimal in two (28.6%). In all seven cases, the common histopathologic findings of peripheral hypoechoic rim on TRUS were loose stromal tissues, few prostatic glands, and sparse infiltration by inflammatory cells. CONCLUSION: The peripheral hypoechoic rim accompanying prostatic inflammation and revealed by TRUS reflects a sparsity of prostate glandular tissue and is thought to be an area in which inflammatory cell infiltration is minimal.

Keyword

Prostate; Prostate, diseases; Prostate, US; Prostatitis

MeSH Terms

Aged
Chronic Disease
Human
Male
Middle Age
Prostate/*pathology
Prostatitis/*pathology/*ultrasonography

Figure

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  Fig. 1 A 64-year-old man with prominent hypoechoic rim seen at Transrectal ultrasonography (TRUS) and severe inflammatory cell infiltration. A. TRUS shows a hypoechoic rim extending to the lateral portion of the prostate (arrows). B. At lower power field, microscopic image shows that the peripheral portion, seen at TRUS as a hypoechoic rim, is composed of loose connective tissue (arrows) (×40). C. The peripheral portion of the gland is composed of fibrous tissue and smooth muscles (×200). Note the sparse infiltration by inflammatory cells. D. Microscopic image of the central portion shows marked infiltration by inflammatory cells (×200).

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  Fig. 2 A 60-year-old man with subtle hypoechoic rim and moderate inflammatory cell infiltration. A. The hypoechoic rim seen at transrectal ultrasonography (TRUS) is less prominent than in Fig 1 (arrows). B. Microscopic image shows loose peripheral connective tissue (arrows) and central glandular tissue with infiltrative inflammatory cells (arrowheads) (×40). C. Image of the peripheral portion reveals sparse infiltration of fibrous tissue and smooth muscle by inflammatory cells (×200). D. Image of the central portion shows that infiltration by inflammatory cells (×200) is less prominent than in Fig. 1.

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