Breda G, Artibani W, Vancini P, Lotto A, Brunetti A, Battaglia G
Eur Urol. 1977;3(3):132-41. doi: 10.1159/000472078.
A case of urinary malakoplakia involving both ureters and the bladder is presented. Ultrastructural data relating to the ureteric lesion are illustrated. Pale, dark and intermediate cells were involved in the pathological process. Features common and specific for these three types of cell are described. Dark cells are thought to be of a histiocytic nature, while the others are of either histiocyte or urothelial origin. Cytoplasmic inclusions were abundant in all three types in the form of single-or multicentred multilamellar bodies. It was not clear whether these were the product of secretion or phagocytosis. Michaelis-Gutmann bodies, on the other hand, were found to be due to the deposition of needle-like crystals inside pre-existing multicentred multilamellar bodies. Pathogens could not be demonstrated for certain. It is felt, therefore, that the aetiology of malakoplakia must be considered as debatable. Biochemical and immunological research directed to the detection of a possible enzyme deficiency is suggested, along with further ultrastructural investigation of the histogenesis of the pale and intermediate cells.
本文报告一例累及双侧输尿管及膀胱的尿路上皮软斑病病例。文中展示了与输尿管病变相关的超微结构数据。病理过程涉及淡色细胞、深色细胞和中间型细胞。描述了这三种细胞类型的共同特征和特异性特征。深色细胞被认为具有组织细胞性质，而其他细胞则起源于组织细胞或尿路上皮。所有三种细胞类型的胞质内都有丰富的包涵体，呈单中心或多中心多层小体形式。尚不清楚这些是分泌产物还是吞噬产物。另一方面，发现米凯利斯-古特曼小体是由于针状晶体沉积在预先存在的多中心多层小体内所致。无法确定病原体。因此，认为软斑病的病因仍存在争议。建议开展生化和免疫学研究以检测可能的酶缺乏情况，并对淡色细胞和中间型细胞的组织发生进行进一步的超微结构研究。
