Ueki Hideto, Nishina Yusuke, Sumii Kenta, Okuno Masato, Taguchi Isao, Kiyonaka Sawami, Kawabata Gaku
The Division of Urology, Kansai Rosai Hospital.
The Division of Anesthesia, Kansai Rosai Hospital.
Hinyokika Kiyo. 2019 Sep;65(9):381-384. doi: 10.14989/ActaUrolJap_65_9_381.
A 74 year-old man presented with complaints of dysuria and miction pain. Since the prostate volume was 43.5 ml, the patient was scheduled for surgical treatment of benign prostatic hyperplasia. However, prostate cancer was suspected from the magnetic resonance imaging findings and a prostate biopsy was performed. No malignant findings were observed in the pathological results, but numerous plasma cells stained positive for IgG4. Abdominal computed tomography showed pancreatic head enlargement with surrounding inflammatory changes and elevated serum IgG4 was also observed. The patient was diagnosed with IgG4-related disease (pancreatitis/prostatitis). Dysuria improved with induction of 30 mg prednisolone. The patient no longer needed to take the α1 blocker and 5α reductase inhibitor. The international prostate symptom score and urine flow measurement indicated that the patient remained in good condition at 18 months since the start of treatment.
一名74岁男性因尿痛和排尿疼痛前来就诊。由于前列腺体积为43.5毫升,该患者被安排接受良性前列腺增生的手术治疗。然而,磁共振成像结果怀疑有前列腺癌,于是进行了前列腺活检。病理结果未观察到恶性病变,但大量浆细胞IgG4染色呈阳性。腹部计算机断层扫描显示胰头肿大并伴有周围炎症改变,血清IgG4也升高。该患者被诊断为IgG4相关疾病(胰腺炎/前列腺炎)。使用30毫克泼尼松龙诱导治疗后尿痛症状改善。患者不再需要服用α1受体阻滞剂和5α还原酶抑制剂。国际前列腺症状评分和尿流测量结果表明,自治疗开始18个月以来,患者状况良好。