前列腺软斑病1例报告并文献复习

目的 探讨诊治前列腺软斑病的方法 和效果.方法 回顾我院诊治的1例前列腺软斑病患者,并进行文献复习.结果 本例患者经病理检查明确诊断,并行经尿道前列腺汽化电切术及抗生素治疗后痊愈.该例发热并有排尿困难及尿痛症状,细菌培养阳性,病理切片可见软斑细胞及M-G小体.结论 前列腺软斑病是一种可治愈的炎症性疾病,多伴随免疫功能障碍,诊断上需病理检查明确并与前列腺癌相鉴别,治疗上可行经尿道前列腺电切术或开放前列腺摘除术,以及敏感抗菌素等药物治疗.     

系统性硬化症合并膀胱软斑病1例报告

系统性硬化症是一种罕见而复杂的自身免疫病,而软斑病是一种罕见的慢性肉芽肿性炎性病变,系统性硬化症合并膀胱软斑病更罕见。本文报道1例系统性硬化症合并膀胱软斑病,患者为中年女性,以血尿和膀胱刺激征为主要临床表现,合并严重腹泻,行经尿道膀胱肿物电切术,术后病理证实为膀胱软斑病。术后服用小剂量泼尼松龙和甲氨蝶呤治疗系统性硬化症...     

泌尿系统软斑病4例诊疗分析及文献回顾

目的:探讨泌尿系统软斑病的诊断、鉴别诊断和治疗策略。方法:分析南京医科大学第一附属医院于2019年1月至2020年12月收治的4例泌尿系统软斑病患者的临床资料并复习相关文献。结果:2例软斑病患者病变位于膀胱,2例位于腹膜后。膀胱软斑病患者的症状主要为尿路刺激症状,腹膜后软斑病患者的症状主要为发热、腰痛。4例患者均伴有免...     

膀胱软斑病6例临床病理分析及预后

目的探讨膀胱软斑病的临床病理特征、发病机制、鉴别诊断及预后。方法对6例膀胱软斑病患者的临床特征、影像学及组织病理学表现进行分析,并复习相关文献。结果组织学形态均可见成片组织细胞样细胞分布,散在淋巴细胞,浆细胞浸润。组织细胞内外部分可见靶环或枭眼状的Michaelis-Gutmann小体(M-G小体即软斑小体)。PAS和普鲁士蓝铁染色阳性。免疫组化CD68弥漫(+),CK(-),Ki-67增殖指数为10%。随访3~18个月,均预后良好。结论软斑病是一种少见的慢性肉芽肿性炎症疾病,全身均可受累,且以泌尿系统(膀胱)最常见。因影像学多表现为实质性占位,而易误诊为肿瘤。病理诊断为金标准,可采用抗生素、手术及免疫治疗相结合的综合治疗方案进行治疗。     

直肠软斑的诊断和治疗(附一例报道)

软斑(malakoplakia)是一种罕见的慢性炎性肉芽肿,主要发生在泌尿生殖系统,累及直肠者更为稀少。直肠软斑诊断困难,其形态与肠道息肉、类癌、脂肪瘤等相似,且往往合并其他多种肠道疾病,这些疾病往往使医师忽略了软斑的存在,导致误诊或漏诊,本文结合文献复习报道直肠软斑一例,以此提高临床医师对这一罕见病的认识水平。临床资料病例,女,73岁。主诉下腹部阵发性隐痛20余日伴大便稀薄,否认发热、呕吐、大便习惯改变及明显消瘦,无尿频、尿急、尿痛及排尿困难等泌尿系症状,否认有特殊慢性疾病外科理论与实践2005年第10卷第5期史、手术史和长期服药…     

右肾肿块为首发表现的多系统软斑症诊治分析

目的探讨软斑症的发病机制、临床表现、病理特征、诊断方法及治疗策略。 方法通过报道1例肾、肝、结肠多系统软斑症的诊断与治疗经过，并结合现有文献对本病进行探讨。患者女性，65岁，因"右侧腰腹部疼痛1个月"就诊，术前影像学检查提示：右肾占位性病变，考虑肾癌并感染可能性大，侵犯结肠肝曲，累及肝右叶。 结果软斑症患者经过超声引导下穿刺活检，腹腔镜下右肾根治性切除+肝部分切除+结肠肝曲切除术切除病变组织，术后病理提示：右侧肾、肝及结肠软斑病。配合抗感染治疗，术后恢复良好，顺利出院。术后1个月随访，患者无腰痛及发热表现，皮疹已消退。复查各项指标正常。全腹增强CT提示：右肾术后缺如，右肾上腺部分切除显示不清；肝右叶下段部分缺如；右侧后腹膜腔少量包裹性积液，腹膜增厚。 结论软斑症非常罕见，多系统软斑症的发病率更低，需要结合临床表现、影像学、分子病理学等进行诊断，该疾病与宿主免疫缺陷有关。对于多系统软斑症，手术仍是积极有效的治疗措施，术后需要长期应用抗生素治疗，能改善症状，但易于复发。     

前列腺软斑病二例报告

前列腺软斑病是一种慢性炎性病变,临床少见,且易与前列腺癌相混淆,从而导致误诊误治。我们１９９７年１２月～１９９８年６月诊治２例,报告如下。例１,５６岁。５个月前出现尿频、尿急、尿痛,夜尿４～５次。在外院经抗生素、ＴＵＲＰ等治疗,效果不佳。入院体检：体温３８．６℃,血压９８／６０ｍｍＨｇ（１ｍｍＨｇ＝０．１３３ｋＰａ）。肛诊前列腺Ⅱ度大,质软,可及散在小结节,表面不光滑。血常规：ＷＢＣ１１．１×１０９／Ｌ,ＲＢＣ３．６８×１０１２／Ｌ,血、尿培养未见致病菌生长,Ｔ细胞亚群均在正常范围。Ｂ超、ＣＴ示…     

膀胱软斑症1例报告并文献复习

目的:提升临床对罕见病膀胱软斑症的认识和探讨对该病诊断治疗方法。方法:通过报告本院收治的1例膀胱软斑症的临床资料、诊治经过,结合国内外文献资料对该病予以讨论,分析该病可能存在的病因,常见的临床表现、诊断方法以及治疗方法的合理选择。结果:经膀胱病损部分电切术+抗生素+膀胱灌注(膀胱黏膜保护剂)治疗,已无明显血尿,尿路刺激征明显改善。嘱患者出院后定期复查尿常规、尿液细菌培养,必要时复查膀胱镜检。结论:膀胱软斑症确诊有赖于膀胱镜活组织病理检查;治疗以长期敏感抗生素为主,手术、免疫疗法也是重要的治疗手段,必要时行联合治疗可以取得更为理想的治疗效果。     

前列腺肉瘤1例并文献复习

目的 探讨前列腺肉瘤的临床特点、诊断及治疗方法.方法 对本院收治的1例前列腺肉瘤病例结合文献进行分析.结果 病检结果提示前列腺肉瘤.结论 前列腺肉瘤为进展快、恶性度高,预后差的肿瘤,需借助病理表现和免疫组化确诊,临床上根据具体病例行个体化治疗.     

前列腺软斑病一例报告

前列腺软斑病一例报告亓宝明刘广庆孙喜波患者，男，５９岁。因尿急、尿频、尿痛，夜尿增多２年，加重并出现尿潴留１５天就诊，于１９９６年２月１８日以前列腺增生并尿潴留收住院。体检：下腹部膨隆，膀胱区叩实。肛诊前列腺增生Ⅱ°，质地韧，右侧叶可触及不规则结节，...     

Transrectal ultrasound and biopsy in diagnosis of malakoplakia of prostate.

We report our experience with the use of transrectal ultrasound and ultrasound-guided needle biopsy in the diagnosis of 4 cases of malakoplakia of the prostate. Prostatic malakoplakia is rare with a total of 25 cases reported in the literature. It may simulate carcinoma on digital rectal examination and transrectal ultrasound. Herein are 4 additional cases in which transrectal ultrasound of the prostate was compatible with carcinoma. Subsequent needle biopsy of the suspicious regions revealed the classic pathologic features of malakoplakia. Malakoplakia is a difficult pathologic diagnosis, and the prevalence of this disease may be underestimated. As the use of transrectal ultrasound becomes more common in diagnosing carcinoma of the prostate, and due to the difficulty in diagnosing malakoplakia pathologically, we recommend maintaining a high index of suspicion for malakoplakia to avoid possible unnecessary radical surgery.     

Three cases of malakoplakia of prostate

Three cases that were confirmed as malakoplakia of the prostate by means of prostatic biopsy are reported here. All of the patients had a previous history of urinary tract infection with Escherichia coli. These are cases that had not been found in the literature in Japan, and they are deemed the eighth, ninth, and tenth cases of prostatic malakoplakia reported in the world literature.     

Malakoplakia of the prostate causing fatal fistula to rectum. A case report

A fatal case of malakoplakia of the prostate is described. The malakoplakia developed after 20 years of chronic prostatitis caused by E. coli and was not prevented by careful antibiotic treatment. Three years after the histological verification malakoplakia invasion caused fistula to rectum. Autopsy revealed no signs of any debilitating diseases.     

Granulomatous prostatitis – an infrequent diagnosis

BACKGROUND: Granulomatous prostatitis is an unusual benign inflammatory process of the prostate. Clinically, it mimics prostatic carcinoma, thus requiring pathological examination for diagnosis. MATERIALS AND METHODS: Histopathological records of 1353 prostate specimens received in the Department of Pathology, Government Medical College, Chandigarh, India, over a period of 8 years (1995-2002) were reviewed and 20 cases of granulomatous prostatitis were retrieved. RESULTS: Out of 20 cases of granulomatous prostatitis, we encountered 12 cases of non-specific granulomatous prostatitis, two cases of xanthogranulomatous prostatitis, two cases of tuberculous prostatitis, two cases of malakoplakia prostate and one case each of granulomatous prostatitis associated with adenocarcinoma prostate and post-surgical palisading granuloma. The diagnosis was made by histopathological examination of Trucut biopsy, transuretheral resection of prostate chips or retropubic prostatectomy specimen. In all the cases, granulomatous prostatitis was an incidental finding. CONCLUSIONS: Non-specific granulomatous prostatitis is the most common type of granulomatous prostatitis. Despite tuberculosis being very common in India, granulomatous prostatitis associated with tuberculosis is not common. Distinction between non-specific and infectious granulomatous prostatitis is important for therapeutic reasons.     

Malakoplakia of prostate

This represents the twenty-second case of malakoplakia of the prostate reported in the world literature. Eighteen patients (81.8%) had complications which may easily cause urinary tract infection. Treatment of these complications, therefore, is important.     

A case of malakoplakia of the testis and epididymis

A forty-two year-old man with left epididymo-testicular malakoplakia was reported. Thirty-two cases of testicular malakoplakia with (5 cases) and without (27 cases) epididymal malakoplakia were reviewed. The mean age was 48. 2 year-old. Two-thirds of the cases suffered from right side involvement. All cases except a few cases received orchiectomy within 2.6 months on average from the onset of the symptoms. Diabetes mellitus, malignant diseases, or chronic renal failure seem to have a causal relation to the development of testicular malakoplakia. Six cases of epididymal malakoplakia were also reviewed.     

Malacoplaquia testicular: aportación de un nuevo caso y revisión de la literatura científica

Malakoplakia is a uncommon chronic granulomatous condition of a benign nature preferentially occurring in the genitourinary tract. Testes are affected in 12% of cases, and the first case of testicular malakoplakia was reported in 1958. Forty cases have been reported worldwide since that date. We report a new case of testicular and epididymal malakoplakia in a 68-year-old male patient diagnosed of complicated orchiepididymitis who underwent orchidectomy to rule out a malignant tumor. The histopathological study demonstrated a chronic inflammatory infiltrate with histiocytes with an eosinophilic cytoplasm containing the characteristic Michaelis-Gutmann bodies diagnostic of malakoplakia.In connection with this new case and because of its unusual presentation, the literature on testicular malakoplakia is reviewed.     

A Case of Cutaneous Malakoplakia in the Head and Neck Region and Review of the Literature

Malakoplakia is a rare inflammatory condition that typically occurs in the urinary tract. The cutaneous form is less prevalent, and most commonly occurs in the perianal or genital regions. Here we present a 61 year old lady with cutaneous malakoplakia of the neck, which was successfully treated with surgical excision and a prolonged course of ciprofloxacin. We follow our case report with a discussion and literature review of all seventeen previously reported cutaneous head and neck malakoplakia cases from the literature. A diagnosis of cutaneous malakoplakia should be considered in nodular, ulcerated or discharging lesions that are refractory to treatment. Histology is essential, not only to diagnose malakoplakia, but also to exclude other important differential diagnoses, such as malignancy. Combined surgical excision and prolonged antibiotic courses appear to have the highest success rate. Antibiotics should be culture specific, but quinolones appear to be the best empirical choice.     

Renal malakoplakia: an underestimate cause of renal failure

Malakoplakia is an inflammatory granulomatous disease induced by defective phagocytic activity of macrophage. Malakoplakia is histologically characterized by the presence of Michaelis-Gutmann bodies in macrophages. Although not uncommon in the genito-urinary tract, isolated malakoplakia of the kidney is rarely found. Its main clinical presentation associates acute renal failure and acute pyelonephritis. The clue for diagnosis of renal malakoplakia is based on renal biopsy showing Michaelis-Gutmann bodies. Establishing the diagnosis of renal malakoplakia is essential as it determines the choice of antibiotics and duration of treatment. Prognosis remains poor, leading frequently to chronic renal failure. In this paper, we report four cases of renal malakoplakia and discuss clinical presentation, biological and pathological features, treatment and prognosis of this disease.     

Renal parenchymal malakoplakia —a case report and review of the literature

Malakoplakia is an inflammatory condition associated with persisting bacterial antigen in macrophages and characterised histologically by the Michaelis-Gutmann body, containing bacterial fragments. We review the pathogenesis of malakoplakia and report a novel form of treatment successfully used in an 8-week-old infant with bilateral renal malakoplakia. The patient presented with an acuteEscherichia coli urinary tract infection and enlarged kidneys. Antibiotic regimes were ineffective, but once the diagnosis was made treatment was changed to an immunosuppressive regime of prednisolone and azathioprine, to which she responded promptly. Renal malakoplakia should be considered in any patient with a urinary tract infection unresponsive to antibiotics and enlarged kidneys. Although a large proportion of patients with malakoplakia have an underlying systemic disorder, which may account for their abnormal macrophage function, the rest demonstrate either an isolated macrophage defect or no detectable anomaly at all. It is in this latter group we suggest that an immunomodulating regime can be curative.