[Cutaneous malacoplakia. An immunohistochemical and ultrastructural case study].
The authors report a case of a 70 year-old man with a past of myelodysplasia and presenting a voluminous lesion of the thigh corresponding to a cutaneous malacoplakia. Histologic study showed a dermo-hypoderma granuloma with numerous Von Hansemann cells containing some Michaelis-Gutmann bodies. Immunohistochemical study showed a positivity of these cells with the antibodies against CD68 (KP1, Mac 387, PGM1), the lysozyme and the alpha-chemotrypsine. Ultrastructural study confirmed the histiocytic origin of this infiltration by showing some regular and voluminous inclusions with a clear center and a peripheral and dense ring, and also some bacteria measuring 3 to 5 microns. Bacteriological study isolated an Escherichia coli. The evolution was favourable after surgical excision and antibiotherapy. Cutaneous malacoplakia is a very rare disease, usually with a perineal localization, and occurring in immunodeficient host. Michaelis-Gutmann bodies are sometimes difficult to identify by light microscopy underlying the rule of the immunohistochemical and the ultrastructural studies to perform the diagnosis.
Chevallier
A
A
Service d'Anatomie Pathologique, Hôpital Pasteur, CHU de Nice, France.
Battaglione
V
V
Brunner
C
C
Michiels
J F
JF
Perrin
C
C
Hofman
P
P
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers; D004927:Escherichia coli Infections / Q000150:complications / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008287:Malacoplakia / Q000209:etiology / Q000473:pathology*; D008297:Male; D012867:Skin / Q000473:pathology* / Q000648:ultrastructure; D012871:Skin Diseases / Q000209:etiology / Q000473:pathology* / Q000601:surgery
D000900:Anti-Bacterial Agents; D015415:Biomarkers