32, 4, 2010, 3.,.. DIAGNOSIS OF NONSPECIFIC GRANULOMATOUS PROSTATITIS IN PATIENTS UNDERGOING PROSTATE BIOPSY UNDER TRANSRECTAL ULTRASOUND GUIDANCE N. Smilov, N. Koleva and I. Lozev Medical Institute Ministry of Interior : - ( ), ( - ) - ( ) 12 ( ). 486.,. 12 (2,5%). 2,8 18,4 ng/ml. 3-, 9 - /. 3-9 -.,, -., -. :,,, - : -.,,. 79, 1606,.: 0888 763 674, e-mail: smilov_nencho@yahoo.com Summary: The aim of the current study is to evaluate retrospectively the data from digital rectal examination (DRE) and transrectal ultrasound (TRUS) examination and the PSA levels in 12 patients with nonspecific granulomatous prostatitis (NSGP) diagnosed histologically. The results of 486 patients from prostate iopsy under TRUS guidance were studied. All patients underwent DRE, transrectal core iopsy of the prostate under TRUS guidance and PSA test. Nonspecific granulomatous prostatitis was found in 12 patients (2,5%). The level of the serum PSA varied from 2,8 to 18,4 ng/ml. The digital rectal examination found 3 patients with local asymmetrical and dense prostate and 9 patients with prostate nodule/s. In 3 patients, the TRUS findings were normal while single or multiple nodules were found in 9 patients. Currently, there is no clinical, iochemical or imaging method capale of diagnosing with sufficient proaility the condition of NSGP. This diagnosis can e defined with certainty with histological test after transrectal core iopsy of the prostate. It is necessary these patients to e followed up in order not to omit the presence or the eventual development of prostate cancer. Key words: nonspecific granulomatous prostatitis, prostate iopsy, transrectal ultrasound, prostate cancer Address for correspondence: N. Smilov, MD, Medical Institute Ministry of Interior, 79 Skoelev lvd., Bg-1606 Sofia, tel.: 0888 763 674, e-mail: smilov_nencho@yahoo.com. -., - -.., -. - ( ), - ( )
..... 33, 4, 2010, 3 ( ) 12 - ( ). 486 -., -.,, - -. 12 (2,5%). - 64,8. (53-75). 2,8 18,4 ng/ml. 3- ( - ) 9 (4 ) (5 ) - - (7 ) (2- - ) / (. 1. 1). -, -. -. - -. - a. 1.. a... - 1. / / 4 5 2 () 3 ( ) 48 (31-67 ) 2,8 18,4 ng/ml < 0,15 ng/ml/cc 4 > 0,15 ng/ml/cc 8 18 2,6-13,2 ng/ml % 11-24% 3- -, 9 /.,.,, -,, (. 2).
34....., 4, 2010, 3 3 6 2,. 8. - 11 24%. 6 3-. a c. 2.. a.... c. o. ( ) Tanner Mc Donald 1943. [22]. 30%. 10 -. ( ),, - [8, 21] (. 2). 2. - [19] 60-70% 3-5% Mycoacterium avium BCG : 20-25% 1-3%., (,,,, ) -,, - [18, 23]. -., - - - - [14]. [3], - [14]. - 60-70% [21]. 0,44% - - 0,77% -, [23]. Makom. -, ( ) 71,5%, 2% 26,5% [13]. Osca Garcia. 5,5-21
..... 35, 4, 2010, 3 4 (19%) [9, 23]. 2,5% -. - - [19, 20]. - - -. - - - (0,5-144 ng/ml) - [1, 17].,, -. - ( ), -. - /, ( - ) [2, 6, 7].,, - [4, 16, 20]. - (. 3), [12, 13]. a. 3. a.... -,,. [18]. - -,. - -, -. ( ). [18, 23]. - - -, - - - -. - - -. - [18]. - [10, 11, 15]. -, CD68 (. 4).. ( ) [12]. -., - - [5].
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