Dhundee J, Maciver A G
Department of Histopathology, Southmead Hospital, Bristol, UK.
Histopathology. 1991 May;18(5):435-41. doi: 10.1111/j.1365-2559.1991.tb00874.x.
Granulomatous prostatitis may result from tuberculosis and fungal infection and has been described following prostatic surgery. In most cases, however, the aetiology is unknown, although it may be due to a reaction to extravasated or altered prostatic secretions. We have investigated cells (macrophages, lymphocytes), serum proteins (fibrinogen, alpha 1-antitrypsin) and prostatic epithelial products (prostatic-specific antigen and prostatic acid phosphatase) in diffuse granulomatous prostatitis (3 cases), focal periacinar prostatic granulomas (9) and focal prostatic infarcts (5), using an immunohistological technique. T-lymphocytes and macrophages are present in diffuse and focal granulomatous prostatitis, but few B-lymphocytes occur. Fibrinogen-related antigen is absent from granulomas, but a small amount is present within infarcts, whereas plentiful alpha 1-antitrypsin was detected both in granulomas and infarcts. Significant reduction in prostatic-specific antigen and acid phosphatase reactivity occurs in granulomatous prostatitis. This suggests that cytokines derived from activated macrophages and T-lymphocytes may be exerting a cell regulatory effect and altering cell secretions, as well as causing destruction of the prostatic epithelium.
肉芽肿性前列腺炎可能由结核和真菌感染引起，也有在前列腺手术后出现的报道。然而，在大多数情况下，病因不明，尽管可能是对前列腺分泌物外渗或改变的一种反应。我们采用免疫组织学技术，对弥漫性肉芽肿性前列腺炎（3例）、局灶性腺泡周围前列腺肉芽肿（9例）和局灶性前列腺梗死（5例）中的细胞（巨噬细胞、淋巴细胞）、血清蛋白（纤维蛋白原、α1-抗胰蛋白酶）和前列腺上皮产物（前列腺特异性抗原和前列腺酸性磷酸酶）进行了研究。弥漫性和局灶性肉芽肿性前列腺炎中存在T淋巴细胞和巨噬细胞，但B淋巴细胞很少。肉芽肿中不存在纤维蛋白原相关抗原，但梗死灶内有少量存在，而在肉芽肿和梗死灶中均检测到大量的α1-抗胰蛋白酶。肉芽肿性前列腺炎中前列腺特异性抗原和酸性磷酸酶反应性显著降低。这表明，活化的巨噬细胞和T淋巴细胞产生的细胞因子可能在发挥细胞调节作用，改变细胞分泌，同时导致前列腺上皮的破坏。
