多系统结核误诊恶性肿瘤1例  

A case of multiple system tuberculosis misdiagnosed as malignant tumor

作　　者：石鹏 战跃福 陈建强 Shi Peng;Zhan Yuefu;Chen Jianqiang(Hainan Medical University First Hospital,Department of Radiology,Hainan Haikou 570100,China;The Third People's Hospital of Shenzhen Longgang District,Department of Radiology,Guangdong Shenzhen 518100,China)

机构地区：[1]海南医学院第一附属医院放射科,海南海口570100 [2]深圳市龙岗区第三人民医院放射科,广东深圳518100

出　　处：《新发传染病电子杂志》2025年第1期82-85,共4页Electronic Journal of Emerging Infectious Diseases

摘　　要：目前肺结核及肺外多发结核的发生率仍较高,但对于肺外结核的确诊率较低。骨关节结核多继发于肺结核,以腰椎结核的发生率最高,表现为脊柱后凸畸形、椎旁脓肿以及骨质破坏。颅内结核的发生多由结核分枝杆菌经血行播散入脑,分为脑膜及脑实质结核。泌尿生殖系统结核中前列腺结核相对罕见,影像及临床表现缺乏特异性,诊断困难。本研究回顾性分析了1例67岁男性患者的罕见前列腺增生伴前列腺结核合并腰椎及颅内多发结核的诊断及治疗过程。患者因夜尿增多、排尿费力1年,加重2月就诊,既往无发热及肺结核病史。前期结合临床及影像学检查高度怀疑前列腺癌并远处转移,最后经病理活检确定为前列腺结核,现总结诊断及治疗过程,旨在提高对肺外结核的诊疗水平,减少漏诊、误诊。At present,the incidence of pulmonary tuberculosis and extrapulmonary multiple tuberculosis is still high,but the diagnosis rate of extrapulmonary tuberculosis is still low.Osteoarticular tuberculosis is secondary to pulmonary tuberculosis,and the incidence of lumbar tuberculosis is the highest,which is manifested by kyphotic deformity,paravertebral abscess and bone destruction.The occurrence of intracranial tuberculosis is mostly caused by the spread of mycobacterium tuberculosis into the brain through blood,which is divided into meningeal and cerebral parenchyma tuberculosis.Prostatic tuberculosis of genitourinary system is relatively rare,imaging and clinical manifestations lack specificity,and diagnosis is difficult.This study retrospectively analyzed the diagnosis and treatment of rare prostatic hyperplasia with prostatic tuberculosis in a 67-year-old man with multiple tuberculosis of the lumbar spine and intracranial.The patient came to the clinic due to increased nocturnal urination and difficulty in urination for 1 year,aggravation for 2 months,and no previous history of fever and tuberculosis.In the early stage,prostate cancer with distant metastasis was highly suspected combined with clinical and imaging examination,and finally prostate tuberculosis was confirmed by pathological biopsy.The following report is made in order to improve the diagnosis and treatment of extrapulmonary tuberculosis and reduce missed diagnosis and misdiagnosis.

关 键 词：前列腺结核 腰椎结核 颅内结核 抗结核治疗 前列腺癌 

分 类 号：R527.4[医药卫生—内科学]