Imaging manifestations of male reproductive system tuberculosis

doi:10.19982/j.issn.1000-6621.20250302

Abstract

Abstract:

Male genital tuberculosis (MGTB) can occur in various organs of male reproductive system, which could be with atypical clinical symptoms or asymptomatic, thus easy to cause missed diagnosis and misdiagnosis. With the development of medical imaging technology, it plays an important role in the diagnosis and differential diagnosis of MGTB. The authors aim to systematically summarize the ultrasound, CT and MRI manifestations of tuberculosis in various organs of male reproductive system, to improve understanding and clinical diagnosis of MGTB.

Key words: Tuberculosis, male genital, Tomography, spiral computed, Ultrasonography, Magnetic resonance imaging, Diagnostic imaging

CLC Number:

R445
R527.4

Fu Xuwen, He Weiyaozhen, Li Xiang. Imaging manifestations of male reproductive system tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(2): 188-196. doi: 10.19982/j.issn.1000-6621.20250302

Figures/Tables 5

References 70

[1]	舒薇, 刘宇红. 笃志创新躬行致远:世界卫生组织《2023年全球结核病报告》结核病科学研究章节解读. 中国防痨杂志, 2024, 46(6):613-617. doi:10.19982/j.issn.1000-6621.20240159.
[2]	Merchant S, Bharati A, Merchant N. Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part I. Indian J Radiol Imaging, 2013, 23(1):46-63. doi:10.4103/0971-3026.113615.
[3]	Kulchavenya E, Kim C, Bulanova O, et al. Male genital tuberculosis: epidemiology and diagnostic. World J Urol, 2012, 30(1):15-21. doi:10.1007/s00345-011-0695-y. pmid: 21604018
[4]	Cherif S, Yoganathan K, Banks T, et al. Unmasking immune reconstitution inflammatory syndrome: a report of tuberculous epididymo-orchitis mimicking a testicular tumour in a Caucasian AIDS patient. Int J STD AIDS, 2017, 28(1):100-103. doi:10.1177/0956462416652536. pmid: 27222288
[5]	Ramachandran A, Das CJ, Razik A. Male genital tract tuberculosis: A comprehensive review of imaging findings and differential diagnosis. Abdom Radiol (NY), 2021, 46(4):1677-1686. doi:10.1007/s00261-020-02811-0. pmid: 33044653
[6]	Farias LABG, Vitoriano FES, Ribeiro CKB, et al. Two cases of testicular tuberculosis in HIV patients with distinct clinical presentations. Trop Doct, 2024, 54(2):176-178. doi:10.1177/00494755231220400.
[7]	Sanches BDA, Tamarindo GH, Maldarine JDS, et al. Telocytes of the male urogenital system: Interrelationships, possible functions, and pathological implications. Cell Biol Int, 2021, 45(8):1613-1623. doi:10.1002/cbin.11612.
[8]	Rodriguez-Takeuchi SY, Renjifo ME, Medina FJ. Extrapulmonary Tuberculosis: Pathophysiology and Imaging Findings. Radiographics, 2019, 39(7):2023-2037. doi:10.1148/rg.2019190109. pmid: 31697616
[9]	Kimura M, Araoka H, Baba H, et al. First case of sexually transmitted asymptomatic female genital tuberculosis from spousal epididymal tuberculosis diagnosed by active screening. Int J Infect Dis, 2018, 73:60-62. doi:10.1016/j.ijid.2018.05.021. pmid: 29879525
[10]	Fu X, Bi Y, Qi M, et al. Computed tomography imaging analysis of hematogenous disseminated pulmonary tuberculosis cases combined with prostate tuberculosis. BMC Med Imaging, 2025, 25(1):212. doi:10.1186/s12880-025-01753-7.
[11]	李翔, 马仲序, 付旭文, 等. 56例附睾结核CT影像表现分析. 中国防痨杂志, 2022, 44(10):1100-1103. doi:10.19982/j.issn.1000-6621.20220208.
[12]	Kumar R. Reproductive tract tuberculosis and male infertility. Indian J Urol, 2008, 24(3):392-395. doi:10.4103/0970-1591.42624.
[13]	Lachkar S, Diouri M, Ibrahimi A, et al. Isolated testicular tuberculosis: A case report. Urol Case Rep, 2024, 57:102869. doi:10.1016/j.eucr.2024.102869.
[14]	Harya SA, Nhungo CJ, Lori JM, et al. Isolated testicular tuberculosis mimicking testicular malignancy in a 45-year-old male treated at a tertiary hospital. Case report and literature review. Int J Surg Case Rep, 2024, 117:109511. doi:10.1016/j.ijscr.2024.109511.
[15]	Zhang X, Su D, Ni T, et al. Contrast-enhanced ultrasound for rare testicular tuberculosis. IDCases, 2024, 38:e2089. doi:10.1016/j.idcr.2024.e02089.
[16]	杨博文, 艾洁尔古丽·麦合苏木, 安信, 等. 喀什地区睾丸/附睾结核10年单中心诊疗经验. 临床泌尿外科杂志, 2024, 39(9):832-838. doi:10.13201/j.issn.1001-1420.2024.09.016.
[17]	张秀丽, 苏航, 陈争光, 等. 二维超声联合微血管血流成像对睾丸结核的诊断价值. 郑州大学学报(医学版), 2024, 59(5):715-718. doi:10.13705/j.issn.1671-6825.2024.04.061.
[18]	边巴次仁, 次旦旺久, 任翠, 等. 睾丸肿瘤与结核的CT表现分析. 国际泌尿系统杂志, 2025, 45(1):77-80. doi:10.3760/cma.j.cn431460-20230712-00019.
[19]	侯民羊, 苟杰. 睾丸结核的CT诊断. 中国医学影像学杂志, 2010, 18(4):381-383. doi:10.3969/j.issn.1005-5185.2010.04.016.
[20]	闫瑞芳, 李学坤, 张改云, 等. MRI诊断附睾睾丸结核. 中国医学影像技术, 2020, 36(10):1517-1520. doi:10.13929/j.issn.1003-3289.2020.10.020.
[21]	王唯伟, 寻静, 项梅, 等. 睾丸结核的MRI表现1例. 医学影像学杂志, 2021, 31(10):1780, 1784. doi:10.3760/cma.j.cmcr.2022.e05195.
[22]	Yang DM, Kim HC, Kim SW, et al. Sonographic findings of tuberculous vasitis. J Ultrasound Med, 2014, 33(5):913-916. doi:10.7863/ultra.33.5.913. pmid: 24764347
[23]	陈燕玲, 吴迪, 陈秀平, 等. 肺结核及并发肺外结核患者淋巴细胞亚群变化的研究及其临床意义. 结核与肺部疾病杂志, 2024, 5(4):294-304. doi:10.19983/j.issn.2096-8493.2024042.
[24]	Cek M, Lenk S, Naber KG, et al. EAU guidelines for the management of genitourinary tuberculosis. Eur Urol, 2005, 48(3):353-362. doi:10.1016/j.eururo.2005.03.008. pmid: 15982799
[25]	成瑞明, 刘罩明, 张铭, 等. 附睾结核的超声分型及其应用价值. 中华超声影像学杂志, 2016, 25(2):163-167. doi:10.3760/cma.j.issn.1004-4477.2016.02.018.
[26]	杨高怡, 张文智, 蒋慧青, 等. 附睾结核超声造影表现分析. 中国超声医学杂志, 2015, 31(11):1048-1050.
[27]	程洁, 邱小伟, 尤四峰, 等. CT及MRI对附睾结核诊断的特征性分析. 实用放射学杂志, 2023, 39(4):615-617, 638. doi:10.3969/j.issn.1002-1671.2023.04.024.
[28]	Man J, Cao L, Dong Z, et al. Diagnosis and treatment of epididymal tuberculosis: a review of 47 cases. PeerJ, 2020, 8:e8291. doi:10.7717/peerj.8291.
[29]	Yang B, Zhou R, Wang X, et al. Magnetic resonance imaging features of epididymal and/or testicular tuberculosis: a case series. BMC Med Imaging, 2025, 25(1):157. doi:10.1186/s12880-025-01699-w. pmid: 40355825
[30]	Jung YY, Kim JK, Cho K. Genitourinary tuberculosis: comprehensive cross-sectional imaging. AJR Am J Roentgenol, 2005, 184(1):143-150. doi:10.2214/ajr.184.1.01840143.
[31]	Michaelides M, Sotiriadis C, Konstantinou D, et al. Tuberculous orchitis US and MRI findings. Correlation with histopathological findings. Hippokratia, 2010, 14(4):297-299.
[32]	张文智, 杨高怡, 王大力, 等. 输精管结核的超声表现分析. 中国超声医学杂志, 2014, 30(8):737-739. doi:10.3969/j.issn.1002-0101.2014.08.022.
[33]	Jing J, Zhuang H, Luo Y, et al. Vas deferens sonographic appearances of tuberculosis lesions of 19 cases of male genital systemic tuberculosis. Medicine (Baltimore), 2019, 98(11):e14843. doi:10.1097/MD.0000000000014843.
[34]	Qi M, Zhang L, Gan W, et al. The Imaging Features and Diagnostic Value of Computerised Tomography in Seminal Duct Tuberculosis. J Multidiscip Healthc, 2023, 16:1395-1402. doi:10.2147/JMDH.S401660. pmid: 37223245
[35]	Pak BK, Kang DM, Kim SH. Vas Deferens Abscess Rupture: A Case Report. J Belg Soc Radiol, 2022, 106(1):70. doi:10.5334/jbsr.2840. pmid: 35974891
[36]	Ye D, Liu X, Yang Y, et al. Case Report: Epididymal NK/T-cell lymphoma and adrenal diffuse large B-cell lymphoma are misdiagnosed as tuberculosis: two case reports and literature review. Front Oncol, 2025, 15:1529049. doi:10.3389/fonc.2025.1529049.
[37]	Yadav S, Singh P, Hemal A, et al. Genital tuberculosis: current status of diagnosis and management. Transl Androl Urol, 2017, 6(2):222-233. doi:10.21037/tau.2016.12.04. pmid: 28540230
[38]	Mishra KG, Ahmad A, Singh G, et al. Tuberculosis of the prostate gland masquerading prostate cancer; five cases expe-rience at IGIMS. Urol Ann, 2019, 11(4):389-392. doi:10.4103/UA.UA_119_18.
[39]	卫宜锐, 王浩, 杨朴深, 等. 前列腺结核与前列腺癌临床误诊分析. 临床误诊误治, 2024, 37(9):1-5. doi:10.3969/j.issn.1002-3429.2024.09.001.
[40]	Baral S, Chhetri RK, Gyawali M, et al. Prostate tuberculosis complicated by huge prostatic abscess: A rare case report from Nepal. Int J Surg Case Rep, 2020, 77:152-156. doi:10.1016/j.ijscr.2020.10.045.
[41]	Yang G, Ruan L. Imaging findings of prostate tuberculosis by transrectal contrast-enhanced ultrasound and comparison with 2D ultrasound and pathology. Br J Radiol, 2022, 95(1129):20210713. doi:10.1259/bjr.20210713.
[42]	Li Y, Dan S, Yang F, et al. Prostate tuberculosis mimicking prostate cancer: Case report and literature review. Medicine (Baltimore), 2023, 102(47):e36172. doi:10.1097/MD.0000000000036172.
[43]	Joshi PV, Shewalkar B, George T, et al. The Great Mimicker-Tuberculosis Involving Prostate and Vertebrae Posing as Metastatic Prostate Carcinoma on FDG PET/CT. Clin Nucl Med, 2020, 45(3):206-208. doi:10.1097/RLU.0000000000002789. pmid: 31652162
[44]	Cheng Y, Huang L, Zhang X, et al. Multiparametric Magnetic Resonance Imaging Characteristics of Prostate Tuberculosis. Korean J Radiol, 2015, 16(4):846-852. doi:10.3348/kjr.2015.16.4.846. pmid: 26175584
[45]	Bour L, Schull A, Delongchamps N, et al. Multiparametric MRI features of granulomatous prostatitis and tubercular prostate abscess. Diagn Interv Imaging, 2013, 94(1):84-90. doi:10.1016/j.diii.2012.09.001.
[46]	王向东, 王亚丽, 高跃丽. 前列腺结核的磁共振弥散加权成像及超声表现. 新发传染病电子杂志, 2020, 5(3):188-190. doi:10.19871/j.cnki.xfcrbzz.2020.03.010.
[47]	Suzuki T, Takeuchi M, Naiki T, et al. MRI findings of granu-lomatous prostatitis developing after intravesical Bacillus Calmette-Guerin therapy. Clin Radiol, 2013, 68(6):595-599. doi:10.1016/j.crad.2012.12.005. pmid: 23384503
[48]	Engin G, Acunas B, Acunas G, et al. Imaging of extrapulmonary tuberculosis. Radiographics, 2000, 20(2):471-488,529-530, 532. doi:10.1148/radiographics.20.2.g00mc07471.quiz.
[49]	Chen Y, Liu M, Guo Y. Proton magnetic resonance spectroscopy in prostate tuberculosis. Urology, 2010, 75(5):1065-1066. doi:10.1016/j.urology.2009.06.069. pmid: 19781746
[50]	William Y, Sugiono M, Diana Prasetiyo P, et al. A Case Report and Literature Review of Prostatic Tuberculosis Masquerading as Prostate Cancer: A Diagnostic Challenge in a Tuberculosis-Endemic Region. Trop Med Infect Dis, 2025, 10(5):145. doi:10.3390/tropicalmed10050145.
[51]	Lee S, Oh YT, Kim HM, et al. Imaging Patterns of Bacillus Calmette-Guerin-Related Granulomatous Prostatitis Based on Multiparametric MRI. Korean J Radiol, 2022, 23(1):60-67. doi:10.3348/kjr.2020.1369.
[52]	刘盼丽, 欧舒斐, 欧陕兴, 等. 35例腹盆腔结核的CT诊断分析. 结核病与肺部健康杂志, 2016, 5(3):180-185. doi:10.3969/j.issn.2095-3755.2016.03.005.
[53]	Reddy MN, Verma S. Lesions of the Seminal Vesicles and their MRI Characteristics. J Clin Imaging Sci, 2014, 4:61. doi:10.4103/2156-7514.143734. pmid: 25396077
[54]	Ocal O, Karaosmanoglu AD, Karcaaltincaba M, et al. Imaging findings of congenital anomalies of seminal vesicles. Pol J Radiol, 2019, 84:e25-e31. doi:10.5114/pjr.2019.82711.
[55]	李翔, 付旭文, 魏佳璐, 等. 精囊腺结核的MRI影像特征分析——附7例精囊腺结核MRI影像表现. 中国防痨杂志, 2023, 45(5):526-530. doi:10.19982/j.issn.1000-6621.20220538.
[56]	Gan W, Bi Y, Fu X, et al. Magnetic Resonance Imaging Manifestations in 13 Cases of Seminal Vesicle Tuberculosis. Infect Drug Resist, 2023, 16:6871-6879. doi:10.2147/IDR.S427561. pmid: 37908784
[57]	Venyo AK. Tuberculosis of the Penis: A Review of the Litera-ture. Scientifica (Cairo), 2015, 2015:601624. doi:10.1155/2015/601624.
[58]	Kawashima A, Sandler CM, Wasserman NF, et al. Imaging of urethral disease: a pictorial review. Radiographics, 2004,24 Suppl 1:S195-S216. doi:10.1148/rg.24si045504.
[59]	Mayilvaganan KR, Naren Satya Srinivas M, Reddy VN, et al. Tuberculosis Penis with ‘Watering Can Penis’ Appearance: Report of a Rare Case with Retrograde Urethrography and Voiding Cystourethrography Findings. Pol J Radiol, 2016, 81:454-457. doi:10.12659/PJR.897943.
[60]	Gangalakshmi C, Sankaramahalingam. Tuberculosis of Glans Penis-A Rare Presentation. J Clin Diagn Res, 2016, 10(12):PD5-PD6. doi:10.7860/JCDR/2016/19163.9057.
[61]	Naeem M, Zulfiqar M, Siddiqui MA, et al. Imaging Manifestations of Genitourinary Tuberculosis. Radiographics, 2021, 41(4):1123-1143. doi:10.1148/rg.2021200154.
[62]	胡玉敬, 边艳珠. ¹⁸F-氟代脱氧葡萄糖正电子发射计算机体层摄影-CT在结核病诊治中的应用价值. 中国防痨杂志, 2023, 45(3):318-322. doi:10.19982/j.issn.1000-6621.20220500.
[63]	李红岩. 肺外结核¹⁸F-FDGPET/CT影像表现分析及临床价值探讨. 武汉:华中科技大学, 2019.
[64]	Ran P, Liang X, Zhang Y, et al. FDG PET/CT in a Case of Bilateral Tuberculous Epididymo-orchitis. Clin Nucl Med, 2019, 44(9):757-760. doi:10.1097/RLU.0000000000002606. pmid: 31107741
[65]	Bai M, Yu Q, Yuan L, et al. Prostate tuberculosis mimicking malignancy on ¹⁸F-FDG PET/CT in a patient with diffuse large B-cell lymphoma: A case report. Medicine (Baltimore), 2024, 103(22):e38296. doi:10.1097/MD.0000000000038296.
[66]	莫纯威, 徐万帮, 唐刚华. 靶向成纤维细胞活化蛋白PET显像剂的研究进展. 国际放射医学核医学杂志, 2022, 46(12):735-741. doi:10.3760/cma.j.cn121381-202203029-00251.
[67]	Yu Q, Xie Q, Zhu X, et al. Increase 68 Ga-FAPI Uptake in Urogenital Tuberculosis. Clin Nucl Med, 2025, 50(1):98-100. doi:10.1097/RLU.0000000000005418.
[68]	梁逸宁, 侯代伦. 结核病影像学诊断年度进展2024. 中华结核和呼吸杂志, 2025, 48(2):175-180. doi:10.3760/cma.j.cn112147-20241031-00650.
[69]	李汶翰, 杨静, 李春华. 人工智能在肺结核影像诊断及耐药性预测中的研究进展. 中国防痨杂志, 2024, 46(9):1098-1103. doi:10.19982/j.issn.1000-6621.20240123.
[70]	王雪静, 黄智, 曾嘉宾, 等. 新一代人工智能在前列腺癌临床诊断的研究进展. 临床外科杂志, 2025, 33(2):118-122. doi:10.3969/j.issn.1005-6483.20242018.