A Case of Malakoplakia Mimicking Prostatic Malignancy

Authors

  • Kshitija M Kale Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India
  • Anitha Padmanabhan Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India
  • Prapti Acharya Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India
  • Nitin M Gadgil Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India

DOI:

https://doi.org/10.21276/apalm.2657

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.

Author Biographies

  • Kshitija M Kale, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India

    Department of Pathology

  • Anitha Padmanabhan, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India

    Department of Pathology

  • Prapti Acharya, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India

    Department of Pathology

  • Nitin M Gadgil, Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, India

    Department of Pathology

References

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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.

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Published

01-02-2020

Issue

Section

Case Report

How to Cite

1.
A Case of Malakoplakia Mimicking Prostatic Malignancy. Ann of Pathol and Lab Med [Internet]. 2020 Feb. 1 [cited 2025 Dec. 13];7(1):C17-19. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/2657