Abstract
Recent improvements in ultrasonographic instruments have enabled us to estimate differences in echographic patterns of prostatic hypertrophy. We recently compared histopathologic findings with echographic pictures of hypertrophic prostate glands obtained at autopsy in an attempt to classify ultrasonographic patterns. Sixty-one cases of prostatic hypertrophy with no other urological disease were studied. After fixing the bladder, rectum, urethra and prostate in the same positions found in the body, we performed horizontal tomography using spectral chair-type (Aloka SSD-520, 5.0 MHz and 7.0 MHz), transrectal ultrasonographic equipment. The histopathological findings were estimated from specimens cut at the same level as the ultrasonogram. Based on the pathological findings, these adenomas were classified into three types : glandular (23 cases), fibromyomatous (18 cases) and mixed (20 cases) . In the glandular type, which consisted mostly of well developed glandular legions, hypoechoic pictures were found in the ultrasonogram. The fibromyomatous lesions, where fibromyomatous tissue was the main component and glandular tissue was sparse, showed hyperechoic pictures in the echograms. Both hyperechoic and hypoechoic patterns were observed in most areas of the mixed type of prostatic hypertrophy. Characteristic echographic patterns for each histopathologic type of hypertrophic prostate were observed in 17 cases (73.9%) of the glandular type, 13 cases (72.7%) of the fibromyomatous type and 14 cases (70.0%) of mixed type. Clear classification of the ultrasonographic pictures into three patterns was difficult in some cases, because of inflamation, stones, etc.
