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Bright echogenic foci in early prostatic carcinoma: sonographic and pathologic correlation
U M Hamper1, S Sheth, P C Walsh
1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
Radiology
|August 1, 1990
Summary
High-resolution transrectal ultrasonography can detect echogenic foci within prostate cancer nodules. These echogenic areas may indicate benign calcifications or, more centrally, high-grade tumors with calcifications and crystalloid deposits.
Area of Science:
- Radiology
- Urologic Oncology
- Medical Imaging
Background:
- Prostate cancer diagnosis often relies on imaging.
- Transrectal ultrasonography (TRUS) is a key tool for evaluating prostate abnormalities.
- Understanding echogenic patterns in prostate tumors is crucial for accurate staging.
Purpose of the Study:
- To investigate the sonographic appearance of echogenic foci within hypoechoic prostate tumors.
- To correlate these echogenic findings with pathological diagnoses.
- To differentiate between benign and malignant causes of echogenicity in prostate cancer.
Main Methods:
- High-resolution transrectal ultrasonography was performed on 160 patients with clinical stage A or B prostate carcinoma.
- Tumor echogenicity (hypoechoic, isoechoic) and the presence/characteristics of focal bright echogenic areas were analyzed.
- Pathological correlation was performed for all identified echogenic foci.
Main Results:
- Eleven patients showed focal bright echogenic areas within hypoechoic tumors.
- Coarse peripheral echoes correlated with calcified corpora amylacea in benign prostate glands.
- Fine, stippled central echoes indicated high-grade tumors with comedonecrosis/calcifications or crystalloid deposits.
Conclusions:
- Echogenic foci can be present within predominantly hypoechoic prostate tumors.
- Sonographic features of echogenic foci can help differentiate benign prostatic calcifications from malignant tumor characteristics.
- TRUS findings of central, fine echogenicity suggest aggressive tumor features requiring further investigation.