Malakoplakia of the prostate diagnosed in patients with benign prostatic hyperplasia and elevated prostate-specific antigen

Fredy Leonardo Muñoz Gonzalez,Jose Luís Ferreira Duque,William Luís De Oliveira,Nelson Brancaccio Dos Santos,Saul Gun

doi:10.23925/1984-4840.2018v20i2a9

Abstract

Malacoplasia é uma doença inflamatória crônica pouco frequente que afeta o aparelho geniturinário, particularmente a bexiga, os rins e os ureteres. O envolvimento isolado da próstata é a forma mais rara. O diagnóstico diferencial do adenocarcinoma da próstata pode ser de extrema dificuldade em virtude das semelhanças clínicas e imaginológicas. Pacientes com hiperplasia benigna de próstata e infecções do trato urinário frequentes podem alertar para o diagnóstico de malacoplasia.

Highlights

The word malakoplakia comes from the Greek malakós and plakós and represents a rare inflammatory disease that was originally described as occurring in the bladder, but which has been detected in the genitourinary and in the gastrointestinal tract, as well as skin, lungs, bones, and mesenteric lymph nodes.It is macroscopically characterised by the presence of soft yellow mucous plaques, with 3 to 4 cm diameter, and slightly elevated
Even though the exact pathogenesis is as yet unknown, it is likely to stem from an abnormal function of macrophages in response to a bacterial infection, most probably caused by Escherichia coli, while the Michaelis-Gutmann bodies are probably the result of deposits of phosphates of calcium and other minerals in these phagosomes, which are overloaded and could be undergoing disintegration.[1]
Its main characteristic is being accompanied by recurring urinary tract infections that can be combined with high Prostatic specific antigen (PSA) reading[2,3] and often leads to suspicion of carcinoma of the prostate.[4]

Summary

Introduction

The word malakoplakia comes from the Greek malakós (soft) and plakós (plaque) and represents a rare inflammatory disease that was originally described as occurring in the bladder, but which has been detected in the genitourinary and in the gastrointestinal tract, as well as skin, lungs, bones, and mesenteric lymph nodes.It is macroscopically characterised by the presence of soft yellow mucous plaques, with 3 to 4 cm diameter, and slightly elevated. Pacientes com hiperplasia benigna de próstata e infecções do trato urinário frequentes podem alertar para o diagnóstico de malacoplasia. Typically there is presence of laminated mineralised concretions known as Michaelis-Gutmann bodies, both inside the macrophages and between the cells.

Results

Conclusion