International Journal of Clinical and Experimental Medicine Research

ISSN Print: 2575-7989 Downloads: 123248 Total View: 1865772
Frequency: quarterly ISSN Online: 2575-7970 CODEN: IJCEMH
Article 10.26855/ijcemr.2019.01.001

Primary Prostate Tuberculosis: A Cause of Raised Prostate Specific Antigen (PSA)

OP Oluwole1, OI Aisuodionoe-Shadrach2, HO Ajibola2, A Atim2

1 Department of Pathology/Forensic Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja, F.C.T, Nigeria.

2 Division of Urology, Department of Surgery, University of Abuja Teaching Hospital, Gwagwalada, Abuja, F.C.T, Nigeria.

*Corresponding author: OP Oluwhole


Published: March 25,2019


Background: The prostate is one of the most common sites for cancer and in contrast prostate tuberculosis seems to be a rare disease. Mycobacterium tuberculosis and cancer look like antagonists; based on this principle BCG-therapy for bladder cancer was established.
Materials and Methods: A retrospective study of primary tuberculosis diagnosed between January to December 2015 was conducted in the Department of Pathology/Forensic Medicine, University of Abuja Teaching Hospital, Gwagwalada, Abuja. The
materials consisted of tissue blocks, glass slides and duplicates histopathology reports of patients whose specimens were received and processed in the Histopathology Laboratory of the hospital. The slides were reviewed blinded by two consultant
pathologists. The variables looked at were age of the patients, consistency of the prostate and histological diagnosis. Informed consent was obtained from the patients and University of Abuja Teaching Hospital IRB (NHREC/12/12/2008a) was obtained
for the study.
Results: Three primary tuberculosis of the prostate was studied on trucut sextant biopsy. The age range of the patients was between 55-74 years. All the three patients were found to have an enlarged hard prostate gland with raised PSA levels ranging from 9-15ng/ml; none of the patients has had history of contact with chronic tuberculosis patients in the remote past. The working diagnosis of the urologist was
prostate cancer but their histopathology results came out to be primary tuberculosis of the prostate.
Conclusion: Although, primary prostatic tuberculosis is a rare disease and a great mimic of prostate cancer, however, with a high index of suspicion and diligent search, it can be diagnosed on histopathology. Once diagnosis has been established a good
outcome can be achieved with anti-tuberculosis drugs.


[1] World Health Organization. (2014). Global tuberculosis report 2014. World Health Organization.
[2] World Health Organization. (2012). Global Tuberculosis Control 2012. World Health Organization.
[3] Orakwe, J. C., & Okafor, P. I. S. (2005). Genitourinary tuberculosis in Nigeria; a review of thirty-one cases. Nigerian
journal of clinical practice, 8(2), 69-73.
[4] Sharma, S. K., & Mohan, A. (2004). Extrapulmonary tuberculosis. Indian Journal of Medical Research, 120, 316-353.
[5] Stay, E. J. (1980). Tuberculosis and adenocarcinoma of prostate gland. Urology, 16(4), 422-424.
[6] Ventura, M. (1966). Unusual histological finding: carcinoma and primary tuberculosis of the prostate. Minerva urologica,
18(6), 208-212.
[7] Simons, B. W., Durham, N. M., Bruno, T. C., Grosso, J. F., Schaeffer, A. J., Ross, A. E., ... & Schaeffer, E. M. (2015). A
human prostatic bacterial isolate alters the prostatic microenvironment and accelerates prostate cancer progression. The
Journal of pathology, 235(3), 478-489.
[8] Kwon, O. J., Zhang, L., Ittmann, M. M., & Xin, L. (2014). Prostatic inflammation enhances basal-to-luminal
differentiation and accelerates initiation of prostate cancer with a basal cell origin. Proceedings of the National Academy
of Sciences, 111(5), E592-E600.
[9] Liu, X., & Goldstein, A. S. (2014). Inflammation promotes prostate differentiation. Proceedings of the National Academy
of Sciences, 111(5), 1666-1667.
[10] Cradon, LRG. (1902). Tuberculosis of the prostate. New England journal of Medicine, 147, 17-19.
[11] Mittel, R., & Veeraraghavam, S. M. (2010) Disseminated Tuberculosis with involvement of the prostate. A case report.
The Indian Journal of Tuberculosis, 57(1), 364-369.
[12] Merchant, S. A. (1993). Tuberculosis of the genitourinary system Part 2: Genital tract Tuberculosis. Indian J Radial
Imaging, 3, 275-286.
[13] Hemal, A. K., Aron, M., Nair, M., & Wadhwa, S. N. (1998). 'Autoprostatectomy': an unusual manifestation in
genitourinary tuberculosis. British journal of urology, 82(1), 140-141.
[14] Kulchavenya, E. (2010). Some aspects of urogenital tuberculosis. Int J Nephr Urol, 2(1), 351-360.
[15] Ratlal, J. M. (2015) Primary Tuberculosis of the prostatic tuberculosis: A rare form of genitourinary tuberculosis. African
Journal of Urology, 21(2), 142-143.
[16] Fujikawa, K., Matsui, Y., Fukuzawa, S., Soeda, A., & Takeuchi, H. (1999). A case of tuberculosis of the prostate.
Scandinavian journal of urology and nephrology, 33(4), 268-269.
[17] Huang, K., Wu, H., Hsu, Y., et al. (2001) Tuberculosis of the prostate. Journal of Urology, 12(3):10-13.
[18] Klis, R., Mioczkowsi, D., & Sosnowski, M. (2006) Tuberculosis of the prostate: Rare case report. Urological polsa, 1, 1-3.
[19] Bhargava, N., & Bhargava, S. K. (2003). Primary tuberculosis of the prostate. Indian journal of radiology and imaging,
13(2), 236.
[20] Aisuodionoe-Shadrach, O. I., Ajibola, H. O., & Oluwole, O. P. (2014) Tuberculosis of the prostate masquerading as
prostate cance in a 74 year old Nigeria. New Nigerian Journal of Clinical Research, 4(6), 451-454.
[21] Aji, S. A., Alhassan, S. U., Mashi, S. A., & Imam, M. I. (2013). Tuberculosis of the Prostate Gland Masquerading Prostate
Cancer: A Case Report. Open Journal of Urology, 3(07), 269.
[22] Singh, J., Sharma, P., Vijay, M. K., Kundu, A. K., & Pal, D. K. (2013). Tuberculosis of the Prostate: Four Cases and a
Review of the Literature. UroToday Int J, 6(1),1-3.
[23] Murugan, P., Brown, R. E., & Zhao, B. (2010). Nonspecific granulomatous prostatitis with prostatic adenocarcinoma.
Indian Journal of Pathology and Microbiology, 53(1), 152.
[24] Kulchavenya, E., & Kholtobin, D. (2015). Prostate Tuberculosis as predisposition for Prostate Cancer. Clin Res Infect Dis,
2(1), 1014.

How to cite this paper

Primary Prostate Tuberculosis: A Cause of Raised Prostate Specific Antigen (PSA)

How to cite this paper: OP Oluwhole, OI Aisuodionoe-Shadrach, HO Ajibola, A Atim. (2019) Primary Prostate Tuberculosis: A Cause of Raised Prostate Specific Antigen (PSA). International Journal o f Clinical and Experimental Medicine Research, 3(1), 93-96.

DOI: 10.26855/ijcemr.2019.01.001