Malakoplakia, a malignant mimic

Parkin, Cameron James; Acland, George; Sulaiman, Ban; Johnsun, Mark Louie; Latif, Edward

doi:10.14440/bladder.2020.818

Cited by 8 publications

(4 citation statements)

References 4 publications

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“…Irradiation of the bladder region may causes radiation cystitis. 3,4 On describing the cytomorphological features in atypical urine samples by TPS, high N: C ratio, hyperchromasia and irregular nuclear border were found to have a high sensitivity in diagnosing HGUC, in the present study (Table 4). It is the objective cytomorphological description, but not the subjective cytology analysis that help to reach the right diagnosis.…”

Section: Discussionsupporting

confidence: 49%

Efficacy of categorization of urothelial malignancy in atypical urine samples by the Paris system for reporting urinary cytology

Thameem A,

Sankar Sundaram,

Deepa Sujatha

2023

Asian J Med Sci

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Background: Urine cytology is an important screening tool of patients for urothelial carcinoma and follow-up of patients. Ease of procurement, cost-effectiveness, and lower turnaround time are the advantages. Aims and Objectives: The aim of the study was to identify the accuracy of TPS criteria in diagnosing HGUC, considering biopsy as the gold standard and to describe the cytomorphological features in atypical urine specimens and categorization as per reference to TPS of reporting urine cytology. Definition – Atypical urine sample: Urine samples of patients with macroscopic hematuria and other unexplained urinary symptoms, suspicious of urothelial malignancy. Materials and Methods: The study was performed on patients attending urology OPD with macroscopic hematuria and other unexplained urinary symptoms, which were suspicious of urothelial malignancy and whose urine cytology and subsequent biopsy specimens were submitted to the Department of Pathology. Continuous sampling of 56 patients was done. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were used to compare TPS with histopathology. SPSS was used to assess correlation, done by diagnostic test evaluation. Results: Age group of study population ranges from 40 to 84 years with mean age of population as 62 years. Sensitivity, specificity, PPV, and NPV of TPS for reporting urinary cytology in the investigation were 85%, 75%, 65.38%, and 90%. Combination of elevated nuclear-to-cytoplasmic ratio, irregular nuclear border, and hyperchromasia was predictive of malignancy. Conclusion: The criteria outlined by TPS facilitated the standardization of urine cytology reporting and significantly increased the sensitivity of diagnosing HGUC.

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Section: Discussionsupporting

confidence: 49%

Efficacy of categorization of urothelial malignancy in atypical urine samples by the Paris system for reporting urinary cytology

Thameem A,

Sankar Sundaram,

Deepa Sujatha

2023

Asian J Med Sci

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“…Malakoplakia has a different prognosis depending on where it occurs. Studies have shown that conservative medical intervention through the use of antibiotics may be effective, but surgical intervention may sometimes be necessary (6,(9)(10)(11)(12). There are only isolated reports on malakoplakia imaging in the literature, which recognize that the imaging findings of malakoplakia often mimic different diseases and cancers.…”

Section: Discussionmentioning

confidence: 99%

“…It usually occurs in men over the age of 60 and may be overtly symptomatic or clinically silent. A puncture biopsy remains the gold standard for diagnosis ( 5 , 6 ). Imaging information on PMP is extremely limited, which may cause misdiagnosis and unnecessary punctures.…”

Section: Introductionmentioning

confidence: 99%

Case report: Prostatic malakoplakia: a rare disease that has a profile mimicking prostate cancer

Ren,

Chen,

Zhang

et al. 2024

Front. Oncol.

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Prostatic malakoplakia (PMP) is a rare inflammatory disease, and misdiagnosis on imaging is a major reason for unnecessary punctures; however, information on imaging is even rarer. Five patients with PMP between May 2022 and February 2023 were enrolled in this study to summarize the imaging manifestations. All patients underwent ultrasound (US)-guided prostate biopsy and were confirmed by pathology, and the presence of prostate cancer was also excluded by pathology. The five patients, with a median age of 71 years (range = 58–74 years), had a median total prostate-specific antigen (T-PSA) of 10.40 ng/mL (range = 1.74–63.42 ng/mL). In two patients, chest computed tomography showed pulmonary infections. All patients underwent magnetic resonance imaging (MRI). Of these patients, four had a Prostate Imaging–Reporting and Data System (PIRADS) score of 5, while one had a score of 4. The lesions were mostly distributed in the peripheral zone of the prostate and appeared as a high signal on T1-weighted imaging (T1WI) and a low signal on T2-weighted imaging (T2WI). In the US examination, four patients had abnormal prostate morphology, with an unsmooth envelope and non-uniform parenchymal echogenicity. Four patients had increased prostate volume. US showed a hypoechoic nodule with non-uniform internal echogenicity, and an abundant internal blood flow signal was detected by color Doppler US. PSA, MRI, and US were not specific for PMP in our study, but we found that a history of co-infection may be helpful in an accurate diagnosis and to avoid unnecessary biopsy.

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“…The first case also occurred in an infant with a history of adrenal hemorrhage. 9 Malakoplakia may mimic other conditions, including inflammatory bowel disease, familial polyposis coli or malignancy, 10 and pathology is necessary to establish the diagnosis. Important differential diagnoses of retroperitoneal masses include megalocytic interstitial nephritis, renal giant cytoplasmic inclusion (as seen in Chediak-Higashi syndrome), xanthogranulomatous pyelonephritis, mycobacterium infection or Langerhans cell histiocytosis.…”

Section: Denouementmentioning

confidence: 99%