Man 49yo, dysuria, clicinal examination detected big lymphnode on hisleft neck ( foto).
Ultrasound examinationof the neck: normalthyroid gland,size of lymphnode of 2cm, hypoechoic without hilus on color doppler( US 1).
On elastoscan,center of this lymphnode is hard 22kPa.
Ultrasound scanning ofpelvis detected prostate having one hypoechoicmass at right lobe ( US 3).
US scanning at epigatric areadetected one mass ellypsoid of 3 cm lyingover aorta(US 4).
Sonologist suggested aprostate cancer with metastasis to lymphnode.
CT scan with CE revealed the mass in prostate hypovascular, no contrast enhancement.looked like necrosis or abscess.
Biopsy of this cervical lymphnode is tuberculosis lymphadenitis (photo )
Punction of prostate mass removed pus specimen, and examination this pus with PCRis TB positiveand high ADA.
Blood test PSA is 2.05 ng/mL.
CONCLUSION: this case is tuberculosis prostate and lymphnode looked like prostate cancer metastasis to cervical lymph node.