A rare case of tuberculous cystitis and pulmonary tuberculosis in a 60-year-old smoker: A case report.

Tuberculous cystitis is a rare manifestation of genito urinary tuberculosis (TB), often presenting with nonspecific urinary symptoms and mimicking bladder cancer. This report presents a case of a 60-year-old male with concurrent pulmonary tuberculosis and tuberculous cystitis. The patient underwent imaging and biopsy for evaluation of hematuria and systemic symptoms. Diagnostic modalities included ultrasound, computed tomography (CT) scan, and polymerase chain reaction (PCR) for Mycobacterium tuberculosis.Imaging revealed a sessile bladder mass with associated hydroureteronephrosis and peri‑vesical fat densification. Additional findings included a left apico-dorsal pulmonary lesion. Biopsy confirmed granulomatous inflammation with caseating necrosis in the bladder. PCR for tuberculosis was positive despite negatives putums mears. Tuberculous cystitis is a diagnostic challenge due to its mimicry of malignancy. This case emphasizes the importance of biopsy and PCR in confirming TB. The coexistence of pulmonary tuberculosis underscores the systemic nature of the disease. This case highlights the diagnostic complexities of extrapulmonary TB and underscores the necessity of thorough investigation in patients with hematuria and atypical imaging findings.