Malacoplakia or Prostate Cancer? Similarities and Differences

Agostinho, Aparecido Donizeti; Corrêa, Luiz Antonio; Amaro, João Luiz; Bacchi, Carlos E.; Camargo, João Lauro Viana de

doi:10.1159/000030284

Cited by 9 publications

(6 citation statements)

References 6 publications

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“…In about half of the cases, the differential diagnosis includes malignancy, mainly because of the presence of a hard nodule on digital rectal examination and the hypoechoic areas seen on transrectal ultrasound imaging. [85][86][87][88][89] Malakoplakia is a poorly circumscribed lesion characterized by diffuse sheets of macrophages, mostly representing epithelioid histiocytes with granular eosinophilic cytoplasm (von Hansemann histiocytes), admixed with lymphocytes, plasma cells, and neutrophils (Figures 17d and e). They contain intracytoplasmic, spherical, sharply demarcated, and often concentrically laminated, basophilic inclusions, known as Michaelis-Gutmann bodies, which represent calcified bacterial debris (Figure 17e).…”

Section: Signet-ring Lymphocytesmentioning

confidence: 99%

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Benign mimics of prostatic adenocarcinoma

Trpkov

2018

Modern Pathology

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Benign mimics present either as common challenges in daily routine practice or may cause diagnostic dilemmas because some are less commonly seen and one may be less familiar in recognizing them. There are a multitude of mimics of prostatic adenocarcinoma, which may represent normal gland structures, benign proliferations, atrophic lesions, hyperplastic or metaplastic changes, and inflammatory processes. Some of them are preferentially found in certain anatomic areas of the prostate, either confined to the prostate, or outside of the gland. Various benign mimics of prostatic carcinoma may be also evaluated based on their morphologic similarity to Gleason patterns 3-5 of prostatic adenocarcinoma. Most of the mimics are easily recognizable in larger specimens, such as TUR of the prostate or radical prostatectomy specimens, but they may pose diagnostic problems when the evaluation is done on limited tissue, such as needle-core biopsies or if prostate specimens are infrequently encountered in practice. Therefore, before signing out a report with a diagnosis of prostatic carcinoma, pathologists should carefully consider and rule out the various benign lesions that may mimic carcinoma. This is particularly relevant in the current prostate biopsy practice which relies on using extended biopsy core templates. The awareness and familiarity with the characteristic features of the mimics and judicial use of additional ancillary tests, including immunohistochemistry can prevent overdiagnosis and false-positive interpretation. This review provides a contemporary update on the broad spectrum of the benign prostatic lesions that can mimic prostate adenocarcinoma, outlines their key morphologic and immunohistochemical diagnostic features, and provides a diagnostic, pattern-based approach in establishing a correct diagnosis and distinguishing them reliably from prostatic adenocarcinoma.

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Section: Signet-ring Lymphocytesmentioning

confidence: 99%

“…Rare cases have been described in which malakoplakia and prostatic carcinoma have been simultaneously found in the prostate. [85][86][87][88][89] The finding of Michaelis-Gutmann bodies essentially excludes a diagnosis of high-grade prostatic carcinoma.…”

Section: Signet-ring Lymphocytesmentioning

confidence: 99%

Benign mimics of prostatic adenocarcinoma

Trpkov

2018

Modern Pathology

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“…The authors have reported such a patient with a raised PSA level of 38 μg/L [ 26]. TRUS can show hypoechoic areas mimicking prostate cancer [ 30] and prostate biopsies are thus essential to establish the diagnosis.…”

Section: Clinical Featuresmentioning

confidence: 99%

Malacoplakia: von Hansemann’s disease

Dasgupta

Womack

Ag³

et al. 1999

BJU International

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“…Ultra-structural examination reveals inflammatory infiltrate rich in plasma cells and histiocytes. These histiocytes differ from tumour cells in their uniform, round or oval vesicular nuclei and finely vacuolated cytoplasm 6 . Within the cytoplasm of these histiocytes are found Michaelis-Guttmann bodies, which are characteristic to this condition.…”

Section: Discussionmentioning

confidence: 90%

Concurrent malakoplakia of cervical lymph nodes and prostatic adenocarcinoma with bony metasta-sis: case report

Gidwani¹,

Gidwani²,

Khan³

et al. 2010

Ghana Medical Journal

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SUMMARYAn unusual case of malakoplakia of the cervical lymph nodes in a patient with bony metastasis from prostrate cancer is reported. An 80-year-old patient with metastatic prostatic cancer presented with bilateral cervical lymphadenopathy, and a hard cervical mass in the left supraclavicular region. Biopsy of the lymph gland revealed the presence of malakoplakia, with no evidence of metastatic prostatic carcinoma. Though co-existence of malakoplakia and adenocarcinoma within the prostrate gland has been reported before, this case is unique, as it highlights the rare occurrence of malakoplakia involving distant nodes in a patient with bony metastatic prostate cancer. This report reflects the fact that things are not always what they seem in medicine, and not infrequently we come across a different pathology which mimics another.

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Malacoplakia or Prostate Cancer? Similarities and Differences

Cited by 9 publications

References 6 publications

Benign mimics of prostatic adenocarcinoma

Benign mimics of prostatic adenocarcinoma

Malacoplakia: von Hansemann’s disease

Concurrent malakoplakia of cervical lymph nodes and prostatic adenocarcinoma with bony metasta-sis: case report

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