0:00

We're talking about benign prostatic

0:02

hypertrophy and classifying it.

0:05

You've seen examples of balanced hypertrophy,

0:08

anterior hypertrophy in other vignettes.

0:10

And you've heard how we classify

0:13

BPH by the location of enlargement.

0:17

Preurethral type 1, retrourethral type

0:20

2, both equally balanced type 3, and

0:23

pedunculated masses obstructing ureter type 4.

0:26

Now here's a pedunculated

0:27

mass, but it's not a type 4.

0:30

It's an example of balanced hypertrophy.

0:32

In other words, here's the

0:33

urethra coming down like this.

0:35

There's a little slit of it there.

0:37

Behind the urethra, there's enlargement.

0:40

And in front of the urethra, there's enlargement.

0:42

So this one's relatively balanced.

0:45

But the posterior superior component has

0:48

a neck that's narrower than the apex.

0:51

So it's starting to pinch off,

0:53

or it's pedunculated into the

0:54

bladder and may get entrapped.

0:57

This is a problem that is more

0:59

commonly seen in individuals.

1:01

with lobar type 2 enlargement, where the central

1:05

zone of the central gland in the posterosuperior

1:09

quadrant is lobulated, markedly, markedly

1:13

hypertrophied, and sometimes, not in this case,

1:16

This one looks like a finger, but sometimes

1:17

it may even have a cauliflower look to it.

1:20

We have multiple lobes

1:21

coming off one central lobe.

1:24

So this is early pedunculation into the

1:27

bladder, in an example of balanced BPH,

1:31

the so-called type 3 pattern of lobar BPH.

Type 3 BPH

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0:00

We're talking about benign prostatic

0:02

hypertrophy and classifying it.

0:05

You've seen examples of balanced hypertrophy,

0:08

anterior hypertrophy in other vignettes.

0:10

And you've heard how we classify

0:13

BPH by the location of enlargement.

0:17

Preurethral type 1, retrourethral type

0:20

2, both equally balanced type 3, and

0:23

pedunculated masses obstructing ureter type 4.

0:26

Now here's a pedunculated

0:27

mass, but it's not a type 4.

0:30

It's an example of balanced hypertrophy.

0:32

In other words, here's the

0:33

urethra coming down like this.

0:35

There's a little slit of it there.

0:37

Behind the urethra, there's enlargement.

0:40

And in front of the urethra, there's enlargement.

0:42

So this one's relatively balanced.

0:45

But the posterior superior component has

0:48

a neck that's narrower than the apex.

0:51

So it's starting to pinch off,

0:53

or it's pedunculated into the

0:54

bladder and may get entrapped.

0:57

This is a problem that is more

0:59

commonly seen in individuals.

1:01

with lobar type 2 enlargement, where the central

1:05

zone of the central gland in the posterosuperior

1:09

quadrant is lobulated, markedly, markedly

1:13

hypertrophied, and sometimes, not in this case,

1:16

This one looks like a finger, but sometimes

1:17

it may even have a cauliflower look to it.

1:20

We have multiple lobes

1:21

coming off one central lobe.

1:24

So this is early pedunculation into the

1:27

bladder, in an example of balanced BPH,

1:31

the so-called type 3 pattern of lobar BPH.

Report

Editorial Note

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

John F. Feller, MD

Chief Medical Officer, HALO Diagnostics. Medical Director & Founder, Desert Medical Imaging. Chief of Radiology, American Medical Center, Shanghai, China.

HALO Diagnostics

Lesson

Introduction

Lesson

Prostate Anatomy

Lesson

Evaluating BPH

Lesson

What's New in PI-RADS 2.1

Lesson

Prostate MRI Imaging Caveats

Lesson

Prostate MRI Case Reviews

Lesson

PI-RADS 2.1 Case Review

Lesson

Multiparametric MRI Case Review with Dr. John Feller

Type 3 BPH