Computed tomography imaging analysis of hematogenous disseminated pulmonary tuberculosis cases combined with prostate tuberculosis.

Objective: The aim of this study is to enhance the understanding of prostate tuberculosis by analyzing clinical data and prostate computed tomography (CT) imaging of patients with hematogenous disseminated pulmonary tuberculosis and prostate tuberculosis.

Methods: Patients with hematogenous disseminated pulmonary tuberculosis and prostate tuberculosis admitted to Kunming Third People's Hospital between January 2018 and December 2024 were enrolled in the study. Their clinical and imaging characteristics were retrospectively analyzed.

Results: A cohort of 11 male patients were included in the study, with only 4 (36.4%) experiencing scrotal swelling and pain. All 11 patients (100.0%) had positive γ-interferon release assay results. More than 90% exhibited a decreased absolute value and percentage of peripheral blood lymphocytes, lower serum albumin and prealbumin levels, elevated C-reactive protein, and an increased erythrocyte sedimentation rate. CT images of prostate tuberculosis predominantly revealed multiple hypodense shadows in the prostate, while contrast-enhanced scans demonstrated annular enhancement or significant enhancement of prostate tissue outside the lesion. Following effective anti-tuberculosis treatment, follow-up CT scans showed lesion size reduction, decreased enhancement around the hypodense lesion, and the emergence of punctate and sand-like calcifications. If tuberculosis involved other organs of the male reproductive system, corresponding CT findings were also observed.

Conclusion: Hematogenous disseminated pulmonary tuberculosis with concurrent prostate tuberculosis is often associated with other extrapulmonary tuberculosis and tuberculosis affecting organs of the reproductive system. Clinical symptoms are generally mild. CT imaging plays a significant role in diagnosing and monitoring this condition.