[An unusual association of malakoplakia and adenocarcinoma of the prostate]. / Asociación inusual de malacoplaquia y adenocarcinoma prostático.

Malakoplakia is a chronic inflammatory process caused by a lysosomal defect in bacterial digestion. Although rare, it occurs more frequently in the genitourinary tract and in patients with immune dysfunction. The bladder is the most commonly affected site, although cases have been reported in other organs, including the prostate gland. Clinically, this lesion can be confused with malignant tumours, both on physical examination and imagining techniques. This is particularly pronounced in the prostate, making the differential diagnosis challenging. Histologically, characteristic aggregates of histiocytes with basophilic intracytoplasmic inclusions composed of calcium and iron salts are found. We present a case diagnosed on transrectal biopsy as acinar adenocarcinoma with a Gleason 5 + 5 = 10 score. Prostatectomy revealed an unusual association of diffuse prostate malakoplakia and an area of acinar adenocarcinoma with a Gleason score of 3 + 4 = 7.

Asociación inusual de malacoplaquia y adenocarcinoma prostático / An unusual association of malakoplakia and adenocarcinoma of the prostate

La malacoplaquia es un proceso inflamatorio crónico causado por un defecto lisosomal en la digestión bacteriana. El trastorno, aunque raro, aparece con mayor frecuencia en pacientes con disfunción inmunitaria y en aparato genitourinario. La vejiga es el sitio más comúnmente afectado, aunque se han informado casos con involucro de otros órganos, incluyendo la glándula prostática. Desde una perspectiva clínica, la lesión puede simular tumores malignos durante la exploración física y en estudios de imagen, en particular en próstata, por lo que el diagnóstico diferencial suele ser desafiante. Su expresión morfológica se caracteriza histológicamente por agregados histiocíticos con inclusiones basófilas intracitoplasmáticas, compuestas por sales de calcio y hierro. Se presenta un caso que fue diagnosticado en biopsia transrectal como adenocarcinoma acinar con suma de Gleason 5 + 5 = 10. En la prostatectomía se evidenció la asociación excepcional de malacoplaquia prostática difusa y un foco de adenocarcinoma acinar Gleason 3 + 4 = 7.(AU)

Malakoplakia is a chronic inflammatory process caused by a lysosomal defect in bacterial digestion. Although rare, it occurs more frequently in the genitourinary tract and in patients with immune dysfunction. The bladder is the most commonly affected site, although cases have been reported in other organs, including the prostate gland. Clinically, this lesion can be confused with malignant tumours, both on physical examination and imagining techniques. This is particularly pronounced in the prostate, making the differential diagnosis challenging. Histologically, characteristic aggregates of histiocytes with basophilic intracytoplasmic inclusions composed of calcium and iron salts are found. We present a case diagnosed on transrectal biopsy as acinar adenocarcinoma with a Gleason 5 + 5 = 10 score. Prostatectomy revealed an unusual association of diffuse prostate malakoplakia and an area of acinar adenocarcinoma with a Gleason score of 3 + 4 = 7.(AU)