Prostate tuberculosis mimicking malignancy on 18F-FDG PET/CT in a patient with diffuse large B-cell lymphoma: A case report

Medicine (Baltimore). 2024 May 31;103(22):e38296. doi: 10.1097/MD.0000000000038296.

Abstract

Background: Prostate tuberculosis (TB) is a rare and often underdiagnosed condition due to its nonspecific symptoms and imaging features, which can mimic malignancies on 18F-fluorodeoxyglucose positron emission tomography (PET) scans. This resemblance poses a challenge in differentiating TB from prostate cancer, especially in patients with preexisting tumors such as diffuse large B-cell lymphoma. The purpose of this study is to highlight the importance of considering TB in the differential diagnosis of patients with atypical imaging findings, even in the presence of known malignancies.

Case: We present a case of a 60-year-old man with diffuse large B-cell lymphoma who was initially misdiagnosed with a prostate tumor based on 18F-fluorodeoxyglucose PET/computed tomography scans. The subsequent ultrasound-guided prostate biopsy confirmed the presence of prostate TB, not malignancy.

Conclusions: This case report underscores the critical role of considering TB as a potential diagnosis in patients with hematological tumors and atypical imaging results. It serves as a reminder for clinicians to exercise caution when interpreting PET/computed tomography scans and to incorporate TB into their differential diagnoses, thereby avoiding misdiagnosis and inappropriate treatment.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Diagnostic Errors
  • Fluorodeoxyglucose F18*
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / diagnostic imaging
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography* / methods
  • Prostate / diagnostic imaging
  • Prostate / pathology
  • Prostatic Neoplasms / diagnostic imaging
  • Radiopharmaceuticals*
  • Tuberculosis, Male Genital / diagnosis
  • Tuberculosis, Male Genital / diagnostic imaging

Substances

  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals