Enríquez-Pineda Óscar Mauricio, Segura-Rivera Jesús Román, Ruiz-Morales José Manuel, Mendoza-Valdés Arturo, Dorantes-Heredia Rita
Departamento de Anatomía Patológica, Hospital y Fundación Clínica Médica Sur, Ciudad de México, México.
Centro Oncológico Integral, Hospital y Fundación Clínica Médica Sur, Ciudad de México, México.
Rev Esp Patol. 2022 Jan-Mar;55(1):46-51. doi: 10.1016/j.patol.2019.06.002. Epub 2019 Aug 22.
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.
软斑病是一种由细菌消化过程中的溶酶体缺陷引起的慢性炎症过程。虽然罕见，但它在泌尿生殖道以及免疫功能障碍患者中更常见。膀胱是最常受累的部位，不过其他器官（包括前列腺）也有病例报道。临床上，无论是体格检查还是影像学检查，这种病变都可能与恶性肿瘤相混淆。这在前列腺中尤为明显，使得鉴别诊断具有挑战性。组织学上，可发现具有由钙盐和铁盐组成的嗜碱性胞质内包涵体的特征性组织细胞聚集。我们报告一例经直肠活检诊断为 Gleason 评分 5 + 5 = 10 的腺泡腺癌病例。前列腺切除术显示弥漫性前列腺软斑病与 Gleason 评分为 3 + 4 = 7 的腺泡腺癌区域存在异常关联。
