Granulomatous prostatitis is a recognized complication of intravesical bacillus Calmette-Guerin immunotherapy of superficial bladder cancer. Of 32 patients receiving such therapy 13 underwent prostatic core biopsy and/or fine needle aspiration for clinical indications. Prostatic induration or nodularity developed in 12 patients and 1 underwent biopsy for staging of known prostatic carcinoma. Granulomatous prostatitis was found in 100 per cent of those patients who underwent biopsy or aspiration, indicating that the incidence of this finding is at least 41 per cent following bacillus Calmette-Guerin immunotherapy. Acid-fast bacilli were demonstrated within the prostate of 3 patients with granulomatous prostatitis. The mean interval between the initiation of therapy and diagnosis of granulomatous prostatitis was 11.5 months. Bacillus Calmette-Guerin related granulomas of the prostate may be differentiated histologically from nonspecific granulomatous prostatitis, allergic prostatitis and postoperative granulomas. The clinical implications of these findings are discussed.

In 279 patients, 335 cytologic samples were obtained from the prostate and correlated with histology obtained by core needle biopsy in 189 cases. Approximately 6% of the cytologic specimens were inadequate for diagnosis. The unconfirmed positive rate for malignancy was 1.6%, the false-negative rate was 27.9%, and the accuracy rate was 89.6%. Granulomatous inflammation was diagnosed in 19 cases, and three cases of tumors other than acinar carcinoma of the prostate were encountered. Based on our experience, cytologic criteria for the diagnosis of prostatic adenocarcinoma are described.

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