サルコイドーシスと鑑別を要した肉芽腫性前立腺炎

A case of nonspecific granulomatous prostatitis confused with sarcoidosis

　53歳，男性。排尿困難を主訴に受診した。PSA 12.9（ng/ml）であったため，前立腺生検を施行した。その結果，乾酪壊死を認めない類上皮細胞肉芽腫が散見され，サルコイドーシスが疑われた。全身検索を施行したが診断基準を満たさず，他のアレルギー疾患や感染症も認めなかったため，非特異性肉芽腫性前立腺炎として経過を観察した。本疾患は前立腺癌および全身肉芽腫性疾患との鑑別上，重要な疾患であると思われる。

The patient was a 53 year-old male with a chief complaint of voiding difficulty. Since his level of prostatic specific antigen（PSA）was 12.9（ng/ml）,prostatic carcinoma was suspected,and prostate biopsy was carried out. The histopathologic examination of the specimen showed,however,non-caseating granulomas. Sarcoidosis in mind,several examinations including laboratory tests,physical findings and radiography were performed,which,however did not suggest the existence of sarcoidosis. In his past medical records,we could not find out any history or evidence of allergic manifestation as well as infectious diseases including tuberculosis. Our final diagnosis was nonspecific granulomatous prostatitis. We decided to follow the patient administeringα1 adrenergic receptor antagonist. His symptom and PSA level were resolved spontaneously. Nonspecific granulomatous prostatitis has clinical significance because of confusion with prostatic carcinoma and sarcoidosis.