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Prostate

Granulomatous lesions

Infectious (Tuberculosis and BCG-therapy related) granulomatous prostatitis


Reviewers: Ali Amin, M.D., (see Reviewers page)
Revised: 7 January 2012, last major update January 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Prostate is the most common site for tuberculosis in male GU tract (involved in >90% of cases with GU tuberculosis), due to hematogenous spread from lungs or direct incasion from urethra

Clinical features
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● Tuberculosis may perforate into urethra and extend into bladder or rectum
● Tuberculosis symptoms: fluctuant tender zones, usually bilateral, on digital rectal examination
● May cause a self limited rise in PSA in acute phase that can remain high for months
● Similar histologic findings due to intravesical treatment with bacillus Calmette-Guerin (bCG) for bladder carcinoma

Treatment
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● None required for bCG therapy, although rarely disseminates as tuberculosis

Micro description
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Tuberculosis:
● Granulomas with/without caseating necrosis next to benign glands
● May calcify or become small and fibrotic, resembling carcinoma

BCG-therapy:
● Causes caseating or non-caseating granulomas located next to benign prostatic glands (not engulfing them)
● Usually AFB negative
● Located along periurethral or transition zone or diffuse

Micro images
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Various images

End of Prostate > Granulomatous lesions > Infectious (Tuberculosis and BCG-therapy related) granulomatous prostatitis


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