Prostate cancer differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]

Overview

Prostate cancer must be differentiated from benign prostatic hypertrophy, renal cancer, renal stones, bladder cancer, and cystitis.

Differential diagnosis

Prostate cancer must be differentiated from:

• Benign prostatic hypertrophy (BPH)
• Renal cancer
• Renal stones
• Bladder cancer
• Cystitis
• Glomerulonephritis
• Prostatitis
• Pyelonephritis

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• Bacterial infection
• Prior history of prostatitis
• Urinary catheterization

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• Perineal pain
• Lower back pain
• Suprapubic pain

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• Enlarged prostate
• Rectal pain

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• Leukocytosis

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• Bacteriuria
• Pyuria
• Microscopic hematuria

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• Edema of the prostate gland with diffuse enlargement

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• Family history of prostate cancer
• Germline mutation of HOXB13
• Black ethnicity
• Age > 50 years

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• Enlarged prostate
• Firm and hard

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• Hematuria
• Positive prostate specific antigen
• High levels of TMPRSS2:ERG and PCA3

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• Focal areas of mass−like enhancement in the peripheral prostate
• Calcifications

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