Fante R, Maiorana A, Fano R A
Istituto di anatomia patologica, Università di Modena.
Pathologica. 1990 May-Jun;82(1079):297-302.
The histological and ultrastructural features of a case of malakoplakia affecting the testis and the epididymis of a 53-year-old man are described. Light microscopy shows a granulomatous inflammatory process, characterized by the accumulation of large mononuclear cells with abundant granular cytoplasm and PAS-positive calcific intracytoplasmic inclusions (so-called Michaelis-Gutman bodies). On E.M., such inclusions appear as concentric lamellated structures with a mineralized core. Although the pathogenesis of malakoplakia is still unclear, an abnormality of the bacteria-digesting function of tissue macrophages, leading to persistence of phagolysosomes, has been postulated. Malakoplakia of testis is a benign entity, which must be differentiated from neoplastic lesions, especially germ cell tumours, and granulomatous disease such as histoplasmosis, mycobacteriosis and idiopathic granulomatous orchitis.
本文描述了一名53岁男性睾丸和附睾发生软斑病的组织学和超微结构特征。光镜下可见肉芽肿性炎症过程,其特征为大量单核细胞聚集,这些细胞胞质丰富且呈颗粒状,胞质内可见PAS阳性的钙化包涵体(即所谓的迈克尔is -古特曼小体)。电镜下,此类包涵体表现为具有矿化核心的同心层状结构。尽管软斑病的发病机制仍不清楚,但推测组织巨噬细胞的细菌消化功能异常会导致吞噬溶酶体持续存在。睾丸软斑病是一种良性病变,必须与肿瘤性病变,尤其是生殖细胞肿瘤,以及肉芽肿性疾病如组织胞浆菌病、分枝杆菌病和特发性肉芽肿性睾丸炎相鉴别。