title: Transrectal ultrasound appearance of prostatic granulomas secondary to bacillus Calmette-Guerin instillation.
abstract: OBJECTIVE
  To our knowledge the transrectal ultrasound appearance of prostatic granulomas occurring after intravesical bacillus Calmette-Guerin (BCG) therapy has not been thoroughly described.
  
  
  METHODS
  A total of 13 men with a history of transitional cell carcinoma of the bladder treated with intravesical BCG underwent transrectal ultrasound followed by prostate biopsy and/or cystoprostatectomy.
  
  
  RESULTS
  Of the 13 patients studied 9 (69.2%) had intensely hypoechoic lesions anteriorly in the transition zone of the prostate on ultrasound images. The lesions were histologically proved to be necrotizing granulomas.
  
  
  CONCLUSIONS
  Prostatic granulomas secondary to BCG instillation appear as distinct, intensely hypoechoic anterior lesions within the transition zone of the prostate. Prostatic adenocarcinoma arising in the transition zone is usually not visible and would not be easily confused with granulomas. However, since transitional cell carcinoma involving the prostate can appear hypoechoic in the transition zone, transrectal or transurethral tissue sampling may be indicated.
authors.affiliation: Department of Urology, Stanford University Medical Center, California, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Terris
authors.forename: M
authors.initials: M
authors.lastname: Macy
authors.forename: F S
authors.initials: FS
authors.lastname: Freiha
mesh_terms: D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D006099:Granuloma / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011469:Prostatic Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000473:pathology; D014463:Ultrasonography; D001749:Urinary Bladder Neoplasms / Q000628:therapy*
chemical_list: D001500:BCG Vaccine