Okçelik Sezgin, Soydan Hasan, Yılmaz İsmail, Yılmaz Ömer, Ateş Ferhat, Karademir Kenan
Clinic of Urology, Gülhane Military Medical Academy Haydarpaşa Hospital, İstanbul, Turkey.
Clinic of Pathology, Gülhane Military Medical Academy Haydarpaşa Hospital, İstanbul, Turkey.
Turk J Urol. 2013 Sep;39(3):204-6. doi: 10.5152/tud.2013.042.
The histopathological report of the biopsy material retrieved from hyperemic areas of the bladder during control cystoscopy of a 70-year-old man who had a bladder cancer diagnosis three years previously, indicated the presence of a carcinoma in situ (CIS). Intravesical immunotherapy treatment was initiated. After severe symptoms of dysuria emerging during intravesical immunotherapy with BCG, the immunotherapy treatment dosage was lowered. His treatment was then discontinued due to the progression of symptoms. A biopsy was performed due to higher prostate spesific antigen (PSA) and digital rectal examination abnormalities which indicated granulomatous prostatitis. An antituberculosis treatment was initiated because the PPD test result was 25 mm and the QuantiFERON test was positive. After one month, the patient's PSA levels were reduced, and his clinical status improved. The symptoms of severe dysuria, sterile pyuria, abnormal digital rectal examination findings and high PSA levels during intravesical BCG treatment should remind us diagnosis of granulomatous prostatitis. It should not be forgotten that diagnosis of granulomatous prostatitis was established histopathologically, and the patient benefited from medical treatment.
一名70岁男性三年前被诊断为膀胱癌，在膀胱镜复查时从膀胱充血区域获取的活检材料的组织病理学报告显示存在原位癌（CIS）。开始进行膀胱内免疫治疗。在用卡介苗进行膀胱内免疫治疗期间出现严重排尿困难症状后，降低了免疫治疗剂量。随后由于症状进展停止了治疗。因前列腺特异性抗原（PSA）升高和直肠指检异常提示肉芽肿性前列腺炎而进行了活检。由于结核菌素试验结果为25mm且QuantiFERON试验呈阳性，开始了抗结核治疗。一个月后，患者的PSA水平降低，临床状况改善。膀胱内卡介苗治疗期间出现的严重排尿困难、无菌性脓尿、直肠指检异常和PSA水平升高的症状应提醒我们诊断肉芽肿性前列腺炎。不应忘记，肉芽肿性前列腺炎的诊断是通过组织病理学确立的，且患者从药物治疗中获益。
