アレルギー性肉芽腫性前立腺炎の1例

Abstract

This is a case report of allergic granulomatous prostatitis and its systemic dissemination. A 45-year-old male visited our hospital with initial symptoms of dysuria, pollakiuria and fever on February 19, 1980. Thereafter, a painless abscess in his left cheek and hard swelling of his right parotid gland appeared. He was hospitalized on March 11 because of hearing difficulties and congestion in the conjunctiva. Physical examination revealed no abnormalities in the chest or abdomen, but a proctological examination showed stone-like hardness of the prostate gland which was the size of a hen's egg. Laboratory findings indicated peripheral eosinophilia and immunoglobulinemia. X-rays showed multiple coin lesions in the chest and multiple cystic changes in the spleen. Biopsies of the cheek lesion and prostate showed eosinophilic granulation accompanied by fibrinoid necrosis and vasculitis. When steroid administration was started, his symptoms and signs showed dramatic but temporary improvement. The allergic lesions then gradually progressed and resisted the steroid therapy. He died on March 13, 1982. In 1972, Towfighi et al. presented 31 cases of nonspecific granulomatous prostatitis with a comprehensive review of the literature. They stated that eosinophilic granulomatous prostatitis with both fibrinoid necrosis and vasculitis caused systemic disease with a poor prognosis. Since the pathological findings in our case showed eosinophilic granulation with fibrinoid necrosis and vasculitis, it was a very rare case of the systemic type of eosinophilic granulomatous prostatitis experienced by Towfighi et al.