Prostate gland & seminal vesicles
Granulomatous lesions
Infectious (tuberculosis and BCG therapy related) granulomatous prostatitis


Topic Completed: 1 January 2012

Minor changes: 3 September 2020

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PubMed search: Infectious granulomatous prostatitis

Ali Amin, M.D.
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Cite this page: Amin A. Infectious (tuberculosis and BCG therapy related) granulomatous prostatitis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/prostatetbbcg.html. Accessed September 21st, 2020.
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
Microscopic (histologic) 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
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