Differential Diagnosis for Elevated PSA in a 76-Year-Old Male
Single Most Likely Diagnosis
- Benign Prostatic Hyperplasia (BPH): This is the most common cause of elevated PSA in older men. BPH is a non-cancerous enlargement of the prostate gland that can cause an increase in PSA levels due to the increased volume of prostate tissue.
Other Likely Diagnoses
- Prostatitis: Inflammation of the prostate gland can cause an elevation in PSA levels. This condition can be acute or chronic and is often caused by bacterial infection.
- Prostate Cancer: While not the most likely diagnosis at this PSA level, prostate cancer is a significant concern in older men and must be considered, especially if there are other risk factors or symptoms present.
Do Not Miss Diagnoses
- High-Grade Prostate Cancer: Although the PSA level is not extremely high, it's crucial not to miss high-grade prostate cancer, which can have a significant impact on mortality if not diagnosed and treated promptly.
- Prostate Abscess: A rare but serious condition that can cause a significant elevation in PSA. It requires urgent medical attention due to the risk of sepsis.
Rare Diagnoses
- Prostatic Infarction: A rare condition where a part of the prostate tissue dies due to a lack of blood supply. This can cause an elevation in PSA levels.
- Granulomatous Prostatitis: A rare form of prostatitis characterized by the presence of granulomas in the prostate tissue. It can be caused by various conditions, including infections and autoimmune diseases.