Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMS
Objectives: Tuberculosis (TB) of the prostate is a very rare disease. Most urologists are not familiar with it. Here, we present our experience with five cases of this disease and a review of literature. Materials and Methods: This is a retrospective study in a tertiary care center (IGIMS, Patna, Bi...
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doaj-4fcbeab8c5c045d394e46cd342a811fe2020-11-25T02:05:57ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342019-01-0111438939210.4103/UA.UA_119_18Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMSKumar Gaurav MishraAhsan AhmadGaurav SinghRajesh TiwariObjectives: Tuberculosis (TB) of the prostate is a very rare disease. Most urologists are not familiar with it. Here, we present our experience with five cases of this disease and a review of literature. Materials and Methods: This is a retrospective study in a tertiary care center (IGIMS, Patna, Bihar, India) from January 2013 to February 2018. Results: All the patients were in their fourth to sixth decades of life. Lower urinary tract symptom was the most common presentation, predominantly irritative symptoms. A history of pulmonary TB was present in one case. Four out of five cases (80%) had a suspicious prostate on the digital rectal examination (DRE) (hard in consistency). Serum prostate-specific antigen (PSA) level was slightly elevated with a mean of 13.24 ng/ml. Urine analysis revealed sterile pyuria in all patients, and the urine culture was negative. The urine for acid-fast bacilli was positive in one case (20%). Mycobacterium tuberculosis culture test was positive in two cases (40%). The transrectal ultrasonogram showed hypoechoic areas with irregular outlines in three cases (60%) and calcification in two cases (40%). Histopathological examination showed chronic granulomatous prostatitis with few Langhans-type giant cells in four cases (80%). All patients were scheduled to receive 6 months of chemotherapy with isoniazid, rifampicin, and ethambutol or pyrazinamide. Conclusion: TB of the prostate may present like cancer prostate with raised serum PSA and suspicious prostate on DRE; hence, a high index of suspicion with a wide range of investigations may be required to achieve a complete diagnosis of prostatic TB.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=4;spage=389;epage=392;aulast=MishraAcid fast bacilligranulomatousprostatetuberculosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kumar Gaurav Mishra Ahsan Ahmad Gaurav Singh Rajesh Tiwari |
spellingShingle |
Kumar Gaurav Mishra Ahsan Ahmad Gaurav Singh Rajesh Tiwari Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMS Urology Annals Acid fast bacilli granulomatous prostate tuberculosis |
author_facet |
Kumar Gaurav Mishra Ahsan Ahmad Gaurav Singh Rajesh Tiwari |
author_sort |
Kumar Gaurav Mishra |
title |
Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMS |
title_short |
Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMS |
title_full |
Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMS |
title_fullStr |
Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMS |
title_full_unstemmed |
Tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at IGIMS |
title_sort |
tuberculosis of the prostate gland masquerading prostate cancer; five cases experience at igims |
publisher |
Wolters Kluwer Medknow Publications |
series |
Urology Annals |
issn |
0974-7796 0974-7834 |
publishDate |
2019-01-01 |
description |
Objectives: Tuberculosis (TB) of the prostate is a very rare disease. Most urologists are not familiar with it. Here, we present our experience with five cases of this disease and a review of literature.
Materials and Methods: This is a retrospective study in a tertiary care center (IGIMS, Patna, Bihar, India) from January 2013 to February 2018.
Results: All the patients were in their fourth to sixth decades of life. Lower urinary tract symptom was the most common presentation, predominantly irritative symptoms. A history of pulmonary TB was present in one case. Four out of five cases (80%) had a suspicious prostate on the digital rectal examination (DRE) (hard in consistency). Serum prostate-specific antigen (PSA) level was slightly elevated with a mean of 13.24 ng/ml. Urine analysis revealed sterile pyuria in all patients, and the urine culture was negative. The urine for acid-fast bacilli was positive in one case (20%). Mycobacterium tuberculosis culture test was positive in two cases (40%). The transrectal ultrasonogram showed hypoechoic areas with irregular outlines in three cases (60%) and calcification in two cases (40%). Histopathological examination showed chronic granulomatous prostatitis with few Langhans-type giant cells in four cases (80%). All patients were scheduled to receive 6 months of chemotherapy with isoniazid, rifampicin, and ethambutol or pyrazinamide.
Conclusion: TB of the prostate may present like cancer prostate with raised serum PSA and suspicious prostate on DRE; hence, a high index of suspicion with a wide range of investigations may be required to achieve a complete diagnosis of prostatic TB. |
topic |
Acid fast bacilli granulomatous prostate tuberculosis |
url |
http://www.urologyannals.com/article.asp?issn=0974-7796;year=2019;volume=11;issue=4;spage=389;epage=392;aulast=Mishra |
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