What differential diagnosis should be done for prostate cancer

Prostate cancer is a notorious and malignant disease. Once you have prostate cancer, the patient will suffer a lot. Most prostate cancer patients are diagnosed as androgen-dependent. The occurrence and deterioration of this patient is actually closely related to androgen. Prostate cancer is a common reproductive disease in men, so what are the methods to identify prostate cancer?

Differential diagnosis 1. Prostatic hyperplasia 2. Prostatic metastasis 3. Bladder cancer

Discussion Prostatic carcinoma is a common malignant tumor in men, accounting for 3.8% of genitourinary tumors. The age of onset is mostly over 60 years old, which is related to endocrine abnormalities. The chance of developing prostate cancer is higher in patients with prostate hyperplasia than in those without prostate hyperplasia. Prostate cancer often arises in the area around the prostate, 95% of which are adenocarcinomas. In the early stage, it is confined to the capsule, and in the late stage, it often invades adjacent organs and metastasizes to distant places. The main clinical manifestation is dysuria. Lumps can often be found during rectal examination.

Key points of imaging diagnosis: ① CT shows obvious enlargement of the prostate, irregular edges, uneven internal density, and slightly low-density foci of varying sizes. After enhancement, they show uneven enhancement. The seminal vesicles may be enlarged, asymmetric, and the bladder-seminal vesicle angle disappears; ② MRI shows a slightly low signal on T1WI, and the signal of the cancerous nodule increases on T2WI, but is still lower than the edge signal; ③ After enhanced scanning, the intensity of the lesion is enhanced. When the seminal vesicle is invaded, the seminal vesicle enlarges and the signal decreases on T2WI; ④ Prostate cancer often metastasizes to bone, and osteoblastic metastases are more common.

Differential diagnosis: Mainly differentiated from prostate hyperplasia: CT examination: The upper border of the normal prostate does not exceed 10mm above the pubic symphysis. When the prostate is moderately or severely enlarged, CT scans usually show that the prostate is 20 to 30mm above the pubic symphysis, or the prostate can still be seen at higher levels, or (and) the transverse diameter of the prostate exceeds 5cm. The prostate can be spherical or elliptical, bilaterally symmetrical, with smooth and sharp edges, mostly uniform density, often with point-like or other shaped calcifications, clear surrounding fat gaps, and normal seminal vesicle triangles. Prostate hyperplasia often pushes upward, squeezing the bottom of the bladder, forming a "double leaf" sign, and sometimes clearly protruding into the bladder. The enlarged prostate is uniformly enhanced on enhanced scans. MRI examination: ① It is spherical or elliptical in shape, symmetrical on both sides, with smooth edges, uniform density, and small dot-like calcification foci are common; ② The hyperplastic prostate nodule T1WI shows a slightly low signal with uniform signal intensity, and T2WI may show isosignal, low signal or high signal; ③ The capsule of the hyperplastic nodule is a ring-shaped low-signal band around it; ④ The fusion of hyperplastic nodules enlarges the central lobe and atrophies the peripheral lobe.