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患者男,34岁。排尿不畅伴尿痛,偶有血尿3个月余,近2天出现排尿困难,尿痛,来院就诊。体检:膀胱区膨隆,可触及肿块。膀胱镜:前列腺中叶增大。尿动力学检查:膀胱逼尿肌收缩力减弱,下尿路梗阻。实验室检查:血常规检查正常。前列腺特异抗原(PSA)1.12 ng/ml(正常0～4),等克分子复合前列腺特异抗原(CPSA)1.00 ng/ml(正常0～3.6)。超声:前列腺炎性改变,占位性病变待排。CT:前列腺区可见一11.0 cm×9.5 cm肿块影,密度不均匀,边界不清,突入膀胱内,膀胱内可见导尿管,增强扫描显示不均匀强化,与精囊腺分界不清,后缘抵直肠前壁(图1、2)。诊断:前列腺肿瘤性病变,累及膀胱及精囊腺。
Patient male, 34 years old. Poor urination with dysuria, occasional hematuria more than 3 months, nearly 2 days dysuria, dysuria, to the hospital. Physical examination: bulging bladder area, palpable mass. Cystoscopy: the middle of the prostate enlargement. Urodynamic examination: Detrusor contractility of the bladder weakens, lower urinary tract obstruction. Laboratory tests: blood tests were normal. Prostate specific antigen (PSA) 1.12 ng / ml (normal 0 to 4), and equal molecular weight prostate specific antigen (CPSA) 1.00 ng / ml (normal 0 to 3.6). Ultrasound: Prostatitis changes, space-occupying lesions to be discharged. CT: A 11.0 cm × 9.5 cm tumor mass was seen in the prostate area, with uneven density, unclear boundary, penetrating into the bladder, urinary catheter in the bladder, uneven enhancement with enhanced scanning, unclear boundary with seminal vesicles, Anterior rectal wall (Figure 1, 2). Diagnosis: Prostate neoplasia, involving the bladder and seminal vesicle.