TY - JOUR
T1 - Prostatic malakoplakia
T2 - clinicopathological assessment of a multi-institutional series of 49 patients
AU - Acosta, Andres M.
AU - Sangoi, Ankur R.
AU - Maclean, Fiona
AU - Trpkov, Kiril
AU - Osunkoya, Adeboye O.
AU - Collins, Katrina
AU - Miyamoto, Hiroshi
AU - Hirsch, Michelle S.
AU - Chan, Emily
AU - Tretiakova, Maria
AU - Mohanty, Sambit K.
AU - Kaushal, Seema
AU - Cornejo, Kristine M.
AU - Aron, Manju
AU - Quiroga-Garza, Gabriela
AU - Arora, Kanika
AU - Nguyen, Jane K.
AU - Williamson, Sean R.
AU - Epstein, Jonathan I.
AU - Matoso, Andres
PY - 2022/10
Y1 - 2022/10
N2 - Prostatic malakoplakia (MP) is rare, with only case reports and small series (< five patients) available in the literature. In this study we analysed an international multi-institutional series of 49 patients with prostatic MP to more clearly define its clinicopathological features. The median age was 67 years and the median serum prostate-specific antigen (PSA) was 7.5 ng/ml. MP was clinically manifest in most cases (28 of 45 patients with data available, 62%). Of 43 patients with detailed clinical history available, 21 (49%) had concurrent or metachronous malignancies (including prostate cancer). Diabetes or insulin resistance was present in 11 patients (26%). Additionally, three patients had a history of solid organ transplantation and one had HIV. Of note, six of 34 patients (18%) without concurrent prostate cancer had an abnormal digital rectal examination and/or lesions on magnetic resonance imaging (MRI) with prostate imaging reporting and data system (PIRADS) scores 4–5. The initial diagnosis was made on core biopsies (25 of 49, 51%), transurethal resection specimens (12 of 49, 24%), radical prostatectomies (10 of 49, 20%), Holmium-laser enucleation (one of 49, 2%) and cystoprostatectomy (one of 49, 2%). Tissue involvement was more commonly diffuse or multifocal (40 of 49, 82%). Von Kossa and periodic acid-Schiff stains were positive in 35 of 38 (92%) and 26 of 27 lesions (96%), respectively. Of note, two cases were received in consultation by the authors with a preliminary diagnosis of mesenchymal tumour/tumour of the specialised prostatic stroma. The present study suggests that prostatic MP is often associated with clinical findings that may mimic those of prostate cancer in a subset of patients. Moreover, MP may be found incidentally in patients with concurrent prostate cancer.
AB - Prostatic malakoplakia (MP) is rare, with only case reports and small series (< five patients) available in the literature. In this study we analysed an international multi-institutional series of 49 patients with prostatic MP to more clearly define its clinicopathological features. The median age was 67 years and the median serum prostate-specific antigen (PSA) was 7.5 ng/ml. MP was clinically manifest in most cases (28 of 45 patients with data available, 62%). Of 43 patients with detailed clinical history available, 21 (49%) had concurrent or metachronous malignancies (including prostate cancer). Diabetes or insulin resistance was present in 11 patients (26%). Additionally, three patients had a history of solid organ transplantation and one had HIV. Of note, six of 34 patients (18%) without concurrent prostate cancer had an abnormal digital rectal examination and/or lesions on magnetic resonance imaging (MRI) with prostate imaging reporting and data system (PIRADS) scores 4–5. The initial diagnosis was made on core biopsies (25 of 49, 51%), transurethal resection specimens (12 of 49, 24%), radical prostatectomies (10 of 49, 20%), Holmium-laser enucleation (one of 49, 2%) and cystoprostatectomy (one of 49, 2%). Tissue involvement was more commonly diffuse or multifocal (40 of 49, 82%). Von Kossa and periodic acid-Schiff stains were positive in 35 of 38 (92%) and 26 of 27 lesions (96%), respectively. Of note, two cases were received in consultation by the authors with a preliminary diagnosis of mesenchymal tumour/tumour of the specialised prostatic stroma. The present study suggests that prostatic MP is often associated with clinical findings that may mimic those of prostate cancer in a subset of patients. Moreover, MP may be found incidentally in patients with concurrent prostate cancer.
KW - genitourinary
KW - granulomatous prostatitis
KW - malakoplakia
KW - prostate
KW - urinary infection
UR - http://www.scopus.com/inward/record.url?scp=85135504583&partnerID=8YFLogxK
U2 - 10.1111/his.14729
DO - 10.1111/his.14729
M3 - Article
C2 - 35876721
AN - SCOPUS:85135504583
SN - 0309-0167
VL - 81
SP - 520
EP - 528
JO - Histopathology
JF - Histopathology
IS - 4
ER -