Guerra João, Pina Joao M, Andrade Vanessa, Lança Miguel, Campos Pinheiro Luís
Urology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, PRT.
Cureus. 2024 Sep 21;16(9):e69890. doi: 10.7759/cureus.69890. eCollection 2024 Sep.
Granulomatous prostatitis (GP) is a rare and benign inflammatory condition of the prostate, often mimicking prostate cancer (PCa) in clinical and radiological evaluations. This study examines the characteristics and diagnostic challenges of GP in a cohort of 12 patients who received Bacillus Calmette-Guérin (BCG) therapy following treatment for non-muscle-invasive bladder urothelial carcinoma. In this case series, we analyze their clinical presentations, MRI findings, and histopathological results. Patients presented with elevated PSA levels and firm or nodular prostates on digital rectal examination, complicating the differentiation from PCa. Multiparametric MRI showed lesions with hypointensity on T2-weighted images, hypersignal on diffusion-weighted imaging and hyposignal on the apparent diffusion coefficient map, further mimicking malignancy. Histopathological examination remains the gold standard for diagnosing GP, distinguishing it from PCa through the identification of granulomas and associated inflammatory cells. This study underscores the importance of awareness and accurate diagnosis of GP to avoid unnecessary biopsies and treatments, highlighting the need for a multidisciplinary approach combining clinical, imaging, and pathological data.
肉芽肿性前列腺炎（GP）是一种罕见的前列腺良性炎症性疾病，在临床和影像学评估中常酷似前列腺癌（PCa）。本研究调查了12例接受卡介苗（BCG）治疗的非肌层浸润性膀胱尿路上皮癌患者中GP的特征及诊断挑战。在这个病例系列中，我们分析了他们的临床表现、MRI表现和组织病理学结果。患者表现为前列腺特异性抗原（PSA）水平升高，直肠指检时前列腺质地硬或有结节，这使得与PCa的鉴别变得复杂。多参数MRI显示病变在T2加权图像上呈低信号，在扩散加权成像上呈高信号，在表观扩散系数图上呈低信号，进一步酷似恶性肿瘤。组织病理学检查仍然是诊断GP的金标准，通过识别肉芽肿和相关炎症细胞将其与PCa区分开来。本研究强调了认识和准确诊断GP以避免不必要的活检和治疗的重要性，突出了结合临床、影像学和病理学数据的多学科方法的必要性。
