Analysis of clinicopathologic characteristics, misdiagnosis and missed diagnosis of 4 malakoplakia cases / 中国肿瘤临床

ABSTRACT

Objective:To analyze the pathogenesis, clinicopathological characteristics, diagnosis, and treatment of the malakoplakia for the purpose of avoiding misdiagnosis and missed diagnosis. Methods:Clinicopathological features of four malakoplakia patients admit-ted to the Shanxi Cancer Hospital from March 2007 to March 2017 were studied by light microscopy, immunohistochemistry, and spe-cific stain technology, combining with a review of literature. Results:The onset age of the 4 patients (two males and two females) ranged 56-76 years (median:63 years). Two patients had malakoplakia in bladder;one patient had malakoplakia in bilateral ureters;and one case had malakoplakia in right pelvic. One patient has a history of systematic lupus erythematosis and diabetes. Malakoplakia is characterized by the accumulation of foam cells and concentrically-layered basophilic inclusions called Michaelis-Gutmann (M-G) bodies. The foam cells were positive for CD68 and PGM-1 by immunohistochemistry, indicating its derivation from the histocyte. M-G bodies were positive for periodic acid-Schiff reaction, iron, and calcium by specific staining technology. Conclusion:Malakoplakia is a rare inflammatory condition and a common urinary tract disease, but it may involve any organ with non-specific symptoms and can form tumor-like nodules that clinically simulate malignancy in various organs. Clinicopathological features can be used as diagnostic markers in malakoplakia diagnosis through specific stain technology.