Korean J Androl.  2011 Aug;29(2):174-176. 10.5534/kja.2011.29.2.174.

A Case of Xanthogranulomatous Prostatitis Concurrent with a Prostatic Abscess

• Min KS
• Oh SY
• Chun JY
• Um JD
• Choi SH
• Jung SJ

• KMID: 2226472
• DOI: http://doi.org/10.5534/kja.2011.29.2.174

Abstract

Xanthogranulomatous prostatitis is a rare inflammatory condition of the prostate. We report a case of xanthogranulomatous prostatitis. An 82-year-old man presented to our emergency department complaining of gross hematuria. A hard, enlarged, non-tender prostate was palpated on digital rectal examination. Urinalysis showed hematuria and pyuria, and the complete blood count (CBC) revealed leukocytosis. The prostate-specific antigen (PSA) level was elevated at 86.8 ng/ml. Computed tomography (CT) showed an enlarged prostate (volume 100 ml) that protruded into the bladder base. In the left lobe of the prostate, a 1.2x1.1-cm abscess was seen. Transurethral resection of the prostate was done. The pathological diagnosis was xanthogranulomatous prostatitis. The natural progression of the disease is unknown because of the paucity of cases and long-term follow-up reports. To evaluate the pathogenesis and long-term features of progression of this disease, more clinical cases should be collected.

Keyword

Prostatitis; Granuloma; Urinary tract infections; Hematuria

MeSH Terms

Abscess
Aged, 80 and over
Blood Cell Count
Digital Rectal Examination
Emergencies
Granuloma
Hematuria
Humans
Leukocytosis
Prostate
Prostate-Specific Antigen
Prostatitis
Pyuria
Urinalysis
Urinary Bladder
Urinary Tract Infections
Prostate-Specific Antigen

Figure

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  Fig. 1. Computed tomography (CT) of the abdomen and pelvis. (A) The coronal view shows an enlargedprostate. (B) The axial view shows focal abscess formation (white arrow) in the left lobe of the prostate.

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  Fig. 2. (A) Microscopically, the TURP specimen reveals foci of granulomatous inflammation, which consists ofdistended glandular lumens surrounded by macrophages and lymphocytes. The granulomas are composed offoam cells, which are macrophages with lipid components (H&E, ×200). (B) The aggregated macrophagesare positive for CD68 immunostaining, which appears brown (×200).

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