Malakoplakia is an inflammatory process that has been rarely reported in the prostate.
Malakoplakia in association with prostatic
carcinoma is exceedingly rare with only 4 previously reported cases. We describe the clinical features and the associated pathology in 4 patients who demonstrated
malakoplakia of the prostate in association with prostatic
adenocarcinoma. Prostatic
malakoplakia presenting in association with prostatic
adenocarcinoma was identified in 4 patients through a search from the records of 3 institutional databases with large in-house and consult uropathology practices. In 2 of the patients the diagnostic needle biopsy contained only prostatic
carcinoma;
malakoplakia in association with prostatic
carcinoma was documented on
prostatectomy, performed 15 and 8weeks after the biopsy, respectively. Both patients experienced urinary
infections during the interval between the biopsy and the
prostatectomy. The third and fourth patient had a long-standing history of "
prostatitis", and acute
urinary tract infection with
urinary retention, respectively. The needle biopsy in both patients showed concomitant
malakoplakia and prostatic
carcinoma. One of them also had
malakoplakia on the initial biopsy containing only atypical glands and on the subsequent one demonstrating
carcinoma. One patient was treated conservatively and one with
prostatectomy. Although coexistent prostatic
carcinoma and
malakoplakia are exceedingly rare,
malakoplakia can likely occur as an exceptionally rare complication of a prostate needle biopsy, particularly in individuals with long-term or acute
urinary tract infections at the time of the biopsy.