A Case of Malakoplakia Mimicking Prostatic Malignancy
Keywords:
Malakoplakia, Prostate, Malignancy mimic, Michealis-Gutmann bodies
Abstract
Malakoplakia is a granulomatous inflammatory condition commonly involving the urogenital tract. Principally it involves the urinary bladder, prostate is a rare site. Clinical and radiological examination sometimes mimics malignancy. Histology remains confirmatory modality for the diagnosis. Hereby we report a case of prostatic malakoplakia in an elderly male who presented with lower urinary tract symptoms in the past fifteen days. Urine routine microscopy showed pus cells; culture report was positive for E. coli. Serum Prostate Specific antigen (PSA) was 4.6 ug/ml. Magnetic Resonance Imaging (MRI) showed a bulky prostate. A 12-core biopsy was done to rule out malignancy and the histopathology showed benign prostatic glands and the stroma with a predominant population of epithelioid histiocytes and the characteristic Michealis-Gutmann bodies. After a course of antibiotic Nitrofurantoin, transrectal ultrasound was repeated which showed reduction in the prostatic volume. Subsequently Trans-Urethral Resection of Prostate (TURP) was done to relieve the persistent lower urinary tract symptoms. Histology showed similar features. Special stains – Von kossa and Prussian Blue highlighted the Michealis-Gutmann bodies.References
1) Matthew Ho, Jeremy Wu, Brian S, Alex K. Prostatic Malakoplakia: a case report with review of literature. Journal of Surgical Case Reports 2018; 3: 1-3.
2) Dasgupta P, Womack C, Turner AG, Blackford HN. Malakoplakia: von Hansemann’s disease. BJU Int. 1999; 84(4): 464-9.
3) Medlicott S, Magi-Galluzzi C, Jimenez R, Trpkov K. Malakoplakia associated with prostatic adenocarcinoma: report of 4 cases and literature review. Ann diagn pathol 2016; 22: 33-7.
4) Dale R, Metcalfe M, Chang S, Jones E, Black P. Malakoplakia of the prostate masquerading as locally advanced prostate cancer on mpMRI. Can Urol Assoc J 2015; 9: 910-2.
5) Kahraman DS, Sayhan S, Diniz G, Ayaz D, Karadeniz T et al. A pit fall in transrectal prostate biopsy: Malakoplakia evaluation of two cases based on the literature review. Case Reports in Pathology 2014; 2014: 1-3.
2) Dasgupta P, Womack C, Turner AG, Blackford HN. Malakoplakia: von Hansemann’s disease. BJU Int. 1999; 84(4): 464-9.
3) Medlicott S, Magi-Galluzzi C, Jimenez R, Trpkov K. Malakoplakia associated with prostatic adenocarcinoma: report of 4 cases and literature review. Ann diagn pathol 2016; 22: 33-7.
4) Dale R, Metcalfe M, Chang S, Jones E, Black P. Malakoplakia of the prostate masquerading as locally advanced prostate cancer on mpMRI. Can Urol Assoc J 2015; 9: 910-2.
5) Kahraman DS, Sayhan S, Diniz G, Ayaz D, Karadeniz T et al. A pit fall in transrectal prostate biopsy: Malakoplakia evaluation of two cases based on the literature review. Case Reports in Pathology 2014; 2014: 1-3.
Published
2020-02-01
Issue
Section
Case Report
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
