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Tuesday 15 December 2015

CASE 352: PROSTATE TUBERCULOSIS, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Man  49yo, dysuria, clicinal examination  detected  big lymph node on his left nec( foto).



Ultrasound  examination of  the neck: normal thyroid  gland, size of  lymph node of  2cm,  hypoechoic  without hilus  on color doppler ( US 1).



On elastoscan, center of this  lymph node is hard  22kPa.



Ultrasound  scanning of pelvis  detected prostate having  one hypoechoic mass   at  right lobe ( US 3).




 US scanning  at epigatric area detected one mass ellypsoid of  3 cm lying over aorta (US 4).


Sonologist suggested a prostate cancer with metastasis to  lymph node.

CT scan with  CE revealed the mass in prostate  hypovascular, no contrast enhancement. looked like  necrosis or abscess.





Biopsy of  this cervical lymph node is tuberculosis lymphadenitis  (photo )


Punction of  prostate mass  removed pus specimen, and  examination this pus with PCR is TB positive and  high ADA.
Blood test  PSA is 2.05 ng/mL.

CONCLUSION:  this case is  tuberculosis prostate and lymph node looked like  prostate cancer metastasis to cervical lymph node.


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