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Malakoplakia of the pancreas with diffuse lymph-node involvement.
Paolo Giovanni Nuciforo1, Laura Moneghini, Paola Braidotti
1Università degli Studi di Milano, Servizio di Anatomia Patologica. Azienda Ospedaliera S.Paolo Via A. di Rudini 8, 20142 Milano, Italy. paolonuciforo@hotmail.com
Virchows Archiv : an International Journal of Pathology
|January 22, 2003
Summary
This study documents a rare case of pancreatic malakoplakia with lymph node involvement in an elderly man. Microscopic analysis revealed characteristic Michaelis-Gutmann bodies, suggesting bacterial origins.
Area of Science:
- Gastroenterology
- Pathology
- Oncology
Background:
- Malakoplakia is a rare chronic inflammatory condition.
- It typically affects the genitourinary tract but can occur in other organs.
- Pancreatic involvement is exceptionally uncommon.
Observation:
- A 74-year-old male presented with pancreatic malakoplakia.
- Associated regional lymphadenopathy was noted.
- Histological examination revealed diffuse histiocytic infiltrate with Michaelis-Gutmann bodies in both pancreas and lymph nodes.
Findings:
- Electron microscopy confirmed malakoplakia and identified bacterial-like structures.
- Microscopic documentation of lymph node involvement in malakoplakia is unprecedented.
- Differential diagnoses included myofibroblastic inflammatory tumor and histiocytic neoplasms.
Implications:
- The findings suggest lymphohematogenous spread of bacteria as a potential cause for nodal involvement.
- Despite its rarity, lymph node involvement did not appear to alter the patient's clinical course.
- This case expands the understanding of malakoplakia's rare presentations and potential spread patterns.