Takeuchi Hisashi, Kuroda Isao, Takizawa Issei, Aoyagi Teiichiro, Tachibana Masaaki
Department of Urology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Inashiki-gun, Ami-mach Chuo, Ibaraki 300-0395, Japan.
Department of Urology, Tokyo Medical University, Tokyo, Japan.
Case Rep Urol. 2016;2016:7812875. doi: 10.1155/2016/7812875. Epub 2016 Mar 13.
A 65-year-old male visited us with complaints of retarded urination, dysuria, gross hematuria, and fever. Urinalysis showed pyuria. Prostatic tumor with lung metastasis was suspected from computed tomography and magnetic resonance imaging. Transurethral prostatic biopsy and bronchoscopic biopsy only revealed fibrinoid necrosis and inflammatory infiltration. Right lateral maxillary sinusitis was also found by MRI. ANCA testing was positive with specificity for anti-PR3 (PR3-ANCA). On the basis of these results, Granulomatosis with polyangiitis (GPA) was diagnosed. GPA involving the prostate gland is unusual, and only a few cases have previously been reported.
一名65岁男性因排尿迟缓、排尿困难、肉眼血尿和发热前来就诊。尿液分析显示有脓尿。根据计算机断层扫描和磁共振成像怀疑为前列腺肿瘤伴肺转移。经尿道前列腺活检和支气管镜活检仅显示纤维蛋白样坏死和炎症浸润。磁共振成像还发现右侧上颌窦炎。抗中性粒细胞胞浆抗体(ANCA)检测呈阳性,抗蛋白酶3(PR3-ANCA)具有特异性。基于这些结果,诊断为肉芽肿性多血管炎(GPA)。累及前列腺的GPA并不常见,此前仅有少数病例报道。