Ikemoto I, Ohishi Y, Onodera S, Yanagisawa M, Tashiro K, Suzuki H, Kishimoto K, Machida T
Hinyokika Kiyo. 1984 Dec;30(12):1851-9.
This is a case report of allergic granulomatous prostatitis and its systemic dissemination. A 45-year-old male visited our hospital with initial symptoms of dysuria, pollakiuria and fever on February 19, 1980. Thereafter, a painless abscess in his left cheek and hard swelling of his right parotid gland appeared. He was hospitalized on March 11 because of hearing difficulties and congestion in the conjunctiva. Physical examination revealed no abnormalities in the chest or abdomen, but a proctological examination showed stone-like hardness of the prostate gland which was the size of a hen's egg. Laboratory findings indicated peripheral eosinophilia and immunoglobulinemia. X-rays showed multiple coin lesions in the chest and multiple cystic changes in the spleen. Biopsies of the cheek lesion and prostate showed eosinophilic granulation accompanied by fibrinoid necrosis and vasculitis. When steroid administration was started, his symptoms and signs showed dramatic but temporary improvement. The allergic lesions then gradually progressed and resisted the steroid therapy. He died on March 13, 1982. In 1972, Towfighi et al. presented 31 cases of nonspecific granulomatous prostatitis with a comprehensive review of the literature. They stated that eosinophilic granulomatous prostatitis with both fibrinoid necrosis and vasculitis caused systemic disease with a poor prognosis. Since the pathological findings in our case showed eosinophilic granulation with fibrinoid necrosis and vasculitis, it was a very rare case of the systemic type of eosinophilic granulomatous prostatitis experienced by Towfighi et al.
这是一例变应性肉芽肿性前列腺炎及其全身播散的病例报告。一名45岁男性于1980年2月19日因排尿困难、尿频和发热等初始症状前来我院就诊。此后,其左侧脸颊出现无痛性脓肿,右侧腮腺出现硬结。因听力减退和结膜充血,他于3月11日住院。体格检查显示胸部和腹部无异常,但直肠指检发现前列腺如鸡蛋大小,质地如石。实验室检查结果显示外周血嗜酸性粒细胞增多和免疫球蛋白血症。X线显示胸部有多个钱币状病灶,脾脏有多个囊性改变。脸颊病灶和前列腺活检显示嗜酸性粒细胞性肉芽组织伴有纤维素样坏死和血管炎。开始使用类固醇治疗时,其症状和体征有显著但短暂的改善。随后变应性病变逐渐进展,对类固醇治疗产生抵抗。他于1982年3月13日死亡。1972年,托菲吉等人报告了31例非特异性肉芽肿性前列腺炎,并对文献进行了全面综述。他们指出,伴有纤维素样坏死和血管炎的嗜酸性粒细胞性肉芽肿性前列腺炎可导致全身性疾病,预后不良。由于我们病例的病理检查结果显示为伴有纤维素样坏死和血管炎的嗜酸性粒细胞性肉芽组织,这是托菲吉等人所报道的全身性嗜酸性粒细胞性肉芽肿性前列腺炎的极为罕见的病例。