Granulomatous Prostatitis after Intravesical BCG Therapy for Bladder Cancer-Report of a Case and Review of the Literature

膀胱內國產卡介苗灌注後引發之肉芽腫性攝護腺炎－病例報告及文獻回顧

李之微(Chih-Wei Lee) ； 于大雄(Dah-Shyong Yu) ； 張聖原(Sun-Yran Chang) ； 馬正平(Cheng-Ping Ma)

《中華民國泌尿科醫學會雜誌》 3卷2期 (1992/06) Pp. 784-787

https://doi.org/10.7024/JUAROC.199206.0784

摘要

使用膀胱內灌注卡介苗來治療表淺性膀胱移行上皮細胞癌為目前大家所公認。有許多文獻也報告因此方法而引發各類泌尿系統的併發症。其中有一種少見之併發症－肉芽腫性攝護腺炎(約佔 0.9%)。本院報告一病例，經由國產卡介苗100毫克膀胱內灌注一年後，發生肉芽種性攝護線炎。以頻尿，尿急及小便變細為主要症狀。診斷是由經尿道攝護線切除術而意外發現。卡介苗膀胱內灌注引發之肉芽腫性攝護線炎在組織病理學上為不連續性肉芽腫，必須和非特異性肉芽腫性攝護線炎、過敏性攝護腺炎、黴菌性攝護腺炎及手術後引發之攝護腺炎作鑑別診斷。我們建議使用經會陰部或直腸施行攝護線切片以區別是否有攝護腺癌之可能。至於因卡介苗膀胱內灌注而引發的肉芽腫性攝護線炎是屬於自癒性，不需任何藥物或手術治療。

並列摘要

Intravesical bacillus Calmette-Guerin (BCG) instillation is a well estalished ther-apy for superficial bladder cancer. Urinary tract complications induced by the BCG have been reported by various investigators. The granulomatous prostatits is an un-common complication with reported incidence of 0.9%. We report a patient, underwent 100mg Taipei-NIPM BCG intravesical instillation wddkly for consecutive 6 doses, devel-oped granulomatous prostatitis one year later. This case initially presented symptoms of prostatism and granulomatous prostatitis was diagnosed incidentally after the TURP. Bacillus Calmette-Guerin related granulomas of the prostate may be differentiated histo-logically from nonspecific granulomatous prosatitis, mycotic prostatitis and postoperative prostatitis. No specific treatment is required since this kind of entity usually is self-limited.

並列關鍵字

granulomatous prostatitis ； Taipei-NIPM BCG ； intravesical instillation ； bladder cancer