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血行播散型肺结核合并前列腺结核病例的计算机断层扫描成像分析

Computed tomography imaging analysis of hematogenous disseminated pulmonary tuberculosis cases combined with prostate tuberculosis.

作者信息

Fu Xu-Wen, Bi Yan, Qi Min, Liu Jing-Liang, Wei Jia-Lu, Gan Wei, He Jin-Tang, Li Xiang

机构信息

Department of Clinical Pharmacy, Yunnan Clinical Medical Center for Infectious Diseases, Kunming Third People's Hospital, Kunming, 650041, China.

Department of Radiology, The People's Hospital of Lincang, Lincang, 677000, China.

出版信息

BMC Med Imaging. 2025 Jul 1;25(1):212. doi: 10.1186/s12880-025-01753-7.

Abstract

OBJECTIVE

The aim of this study is to enhance the understanding of prostate tuberculosis by analyzing clinical data and prostate computed tomography (CT) imaging of patients with hematogenous disseminated pulmonary tuberculosis and prostate tuberculosis.

METHODS

Patients with hematogenous disseminated pulmonary tuberculosis and prostate tuberculosis admitted to Kunming Third People's Hospital between January 2018 and December 2024 were enrolled in the study. Their clinical and imaging characteristics were retrospectively analyzed.

RESULTS

A cohort of 11 male patients were included in the study, with only 4 (36.4%) experiencing scrotal swelling and pain. All 11 patients (100.0%) had positive γ-interferon release assay results. More than 90% exhibited a decreased absolute value and percentage of peripheral blood lymphocytes, lower serum albumin and prealbumin levels, elevated C-reactive protein, and an increased erythrocyte sedimentation rate. CT images of prostate tuberculosis predominantly revealed multiple hypodense shadows in the prostate, while contrast-enhanced scans demonstrated annular enhancement or significant enhancement of prostate tissue outside the lesion. Following effective anti-tuberculosis treatment, follow-up CT scans showed lesion size reduction, decreased enhancement around the hypodense lesion, and the emergence of punctate and sand-like calcifications. If tuberculosis involved other organs of the male reproductive system, corresponding CT findings were also observed.

CONCLUSION

Hematogenous disseminated pulmonary tuberculosis with concurrent prostate tuberculosis is often associated with other extrapulmonary tuberculosis and tuberculosis affecting organs of the reproductive system. Clinical symptoms are generally mild. CT imaging plays a significant role in diagnosing and monitoring this condition.

摘要

目的

本研究旨在通过分析血行播散型肺结核合并前列腺结核患者的临床资料及前列腺计算机断层扫描(CT)影像,提高对前列腺结核的认识。

方法

纳入2018年1月至2024年12月在昆明市第三人民医院收治的血行播散型肺结核合并前列腺结核患者。对其临床及影像特征进行回顾性分析。

结果

本研究共纳入11例男性患者,仅4例(36.4%)出现阴囊坠胀疼痛。11例患者γ-干扰素释放试验结果均为阳性。90%以上患者外周血淋巴细胞绝对值及百分比降低,血清白蛋白和前白蛋白水平降低,C反应蛋白升高,血沉增快。前列腺结核的CT图像主要表现为前列腺内多发低密度影,增强扫描显示病变外前列腺组织呈环形强化或明显强化。有效抗结核治疗后,随访CT显示病灶缩小,低密度病灶周围强化减轻,出现点状及砂粒样钙化。若结核累及男性生殖系统其他器官,也可见相应CT表现。

结论

血行播散型肺结核合并前列腺结核常合并其他肺外结核及累及生殖系统器官的结核。临床症状一般较轻。CT影像在本病的诊断及病情监测中发挥重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75cc/12211806/6326cf7f5157/12880_2025_1753_Fig1_HTML.jpg

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