A CASE OF MALACOPLAKIA WITH INVOLVEMENT OF THE PROSTATE GLAND

Malakoplakia: A Pseudoneoplastic Disease of the Rectum

A review of the literature on extraurinary malakoplakia is followed by the description of a typical case, located in the rectum, whose clinical and rectoscopic features suggested the existence of neoplastic disease. This condition should therefore be borne in mind in the course of differential diagnosis of anorectal tumors.

Malakoplakia of testis

Two cases of malakoplakia of the testis are reported. Ultrastructural studies were performed in both cases and confirmed the histiocytic nature of the large cells seen in this granulomatous process. Characteristic Michaelis-Gutmann bodies are identified in those macrophages and seem to originate from altered lysosomes. From these observations and a review of the literature, the possible physiopathogenesis of the disease is summarized, and comments are made on the treatment of malakoplakia.

An unusual case of supraclavicular and colonic malakoplakia--a light and ultrastructural study

A case of malakoplakia of the supraclavicular region and colon in a 41-year-old patient is presented. Clinical, histopathological, histochemical and ultrastructural features are described. The etiology and pathogenesis are discussed. Malakoplakia is a chronic inflammatory disorder probably due to an abnormal response to infection with Gram negative bacteria, most likely Escherichia coli or Klebsiella. The disease is characterised by the accumulation of macrophages intermixed with plasma cells and lymphocytes. The malakoplakic cells are laden with phagolysosomes which may provide a suitable biochemical environment for the deposition of calcium to form the pathognomonic Michaelis-Gutmann bodies. Ultrastructural examination enhances the accuracy of diagnosis since it highlights the presence of lysosomes, phagolysosomes, Michaelis-Gutmann bodies, and intact E. coli or their remnants.

Three cases of malakoplakia of prostate

Three cases that were confirmed as malakoplakia of the prostate by means of prostatic biopsy are reported here. All of the patients had a previous history of urinary tract infection with Escherichia coli. These are cases that had not been found in the literature in Japan, and they are deemed the eighth, ninth, and tenth cases of prostatic malakoplakia reported in the world literature.

Malakoplakia of the prostate: a report of two cases and a review of the literature

Two cases of malakoplakia of the prostate are documented, bringing the total described in the world literature to 15. This literature is reviewed, and typical features of the condition are established. The majority of the cases have had proven previous episodes of Escherichia coli infection of the urinary tract, but bacilliform organisms have yet to be demonstrated in the diseased prostatic tissue. Five of the reported cases have also had important additional disease, including three instances of malignant lung tumour. Finally, it is emphasised that recognition of prostatic malakoplakia as an entity will prevent its confusion with prostatic carcinoma.

Malakoplakia of kidney simulating renal neoplasm

In a nine-year-old girl with renal hypertension and a urinary infection, angiographic studies of the left kidney suggested an intrarenal pheochromocytoma. After nephrectomy, the kidney was found to contain only a cystic lesion characterized by multiple small, friable excrescences. Under the light microscope these appeared to be formed by granulovacuolated macrophages. Electron microscopy showed intracytoplasmic inclusion identified as Michaelis-Gutmann bodies in various stages of formation. Images suggestive of degraded bacteria were also observed within phagolysosomes.

Malacoplakia of the prostate confused with clear cell carcinoma

Primary malacoplakia of the prostate is a rare benign disease, which is frequently mistaken for carcinoma and granulomatous prostatis. The surgical and clinical course of a patient with obstructive hypertrophy of the prostate is reviewed after an initial incorrect diagnosis of clear cell carcinoma. Experience in defining the lesion during the transurethral resection is presented. The pathogenesis, morphological structure and unique microscopic appearance of malacoplakia, characterized by large mononuclear cells associated with small laminated concretions, are described and illustrated.

Malacoplakia of the prostate in an immunosuppressed patient

Malacoplakia predominantly affects the bladder but occasionally involves other sites. The third case of malacoplakia of the prostate, occurring in a renal transplant patient who was receiving prednisone for immunosuppression, is reported. Modification of phagocytosis and the normal inflammatory response to bacterial infection by the steroid may have been of major importance in the genesis of malacoplakia.

Malakoplakia of the prostate

A case a malakoplakia of the prostate is reported, the fourth case in this site. The clinical features, histology and ultrastructure are described.

Malakoplakia of the prostate: a morphological and biochemical study

A case of malakoplakia of the prostate is presented. Electron microscopic appearances support the origin of the Michaelis-Gutmann bodies from phagolysosomes in the histiocytes characteristic of the lesion. Biochemical analysis revealed the presence of muramic acid in the prostate with malakoplakia. This amino sugar is characteristic of bacterial cell walls and despite the absence of demonstrable bacteria in the affected tissues indicates the involvement of bacteria in the disease process.

Malakoplakia of the colon

A case of malakoplakia of the colon in a young man who presented with symptoms and signs suggestive of ulcerative colitis is reported. It is suggested that a careful search for Michaelis-Guttmann bodies in all chronic inflammatory lesions may reveal a much higher incidence of malakoplakia.