Legesse Tesfaye Kebede, Issa Semira Abrar, Yaynishet Yodit Abraham, Dessie Tesfahun Amsal, Gebremariam Tewodros Yalew, Reta Birhanu Kassie
Department of Radiology, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
Department of Surgery, Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia.
Ethiop J Health Sci. 2024 Oct;34(Spec Iss 1):67-72. doi: 10.4314/ejhs.v34i1.10S.
Tuberculosis (TB) remains the deadliest infectious disease globally, with the kidneys being the most frequently affected organ in the genitourinary system. Isolated prostate involvement by tuberculosis is rare and may mimic prostate cancer. This case report aims to highlight the diagnostic challenges and therapeutic responses associated with isolated prostate tuberculosis, particularly in the context of significantly elevated prostate-specific antigen (PSA) levels in a TB-endemic region.
A 69-year-old male was referred to Tikur Anbessa Specialized Hospital (TASH) with obstructive lower urinary tract symptoms (LUTS) lasting seven months. He had previously undergone transurethral resection of the prostate (TURP), with histopathological findings suggestive of benign prostatic hyperplasia (BPH). Further investigation revealed an extremely elevated PSA level of 1768 ng/ml. Magnetic Resonance Imaging (MRI} raised high suspicion for locally advanced prostate cancer; however, a repeat biopsy and histopathology ultimately diagnosed TB prostatitis. The patient responded successfully to anti-tuberculosis therapy.
Isolated prostate involvement by M. tuberculosis is rare, and extremely elevated PSA levels are unusual. Histopathological examination is a confirmatory test, but results can be falsely negative if a representative sample is not obtained. Therefore, a high degree of clinical suspicion, particularly in endemic areas, along with repeat biopsy, is crucial for accurate diagnosis.
结核病仍然是全球最致命的传染病，肾脏是泌尿生殖系统中最常受累的器官。孤立性前列腺结核受累罕见，可能会被误诊为前列腺癌。本病例报告旨在强调与孤立性前列腺结核相关的诊断挑战和治疗反应，特别是在结核病流行地区前列腺特异性抗原（PSA）水平显著升高的情况下。
一名69岁男性因持续7个月的下尿路梗阻症状（LUTS）被转诊至提库尔·安贝萨专科医院（TASH）。他此前接受过经尿道前列腺切除术（TURP），组织病理学结果提示良性前列腺增生（BPH）。进一步检查发现PSA水平极高，达1768 ng/ml。磁共振成像（MRI）高度怀疑为局部晚期前列腺癌；然而，再次活检和组织病理学最终诊断为结核性前列腺炎。患者对抗结核治疗反应良好。
结核分枝杆菌孤立性前列腺受累罕见，PSA水平极高也不常见。组织病理学检查是确诊试验，但如果未获取代表性样本，结果可能会出现假阴性。因此，高度的临床怀疑，特别是在流行地区，以及再次活检，对于准确诊断至关重要。
