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

Authors: Ali Amin, M.D. (see Authors page)

Revised: 19 July 2016, last major update January 2012

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PubMed search: Infectious granulomatous prostatitis
Definition / General
  • 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
  • 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
  • None required for bCG therapy, although rarely disseminates as tuberculosis
Micro Description
  • 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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