title: Malakoplakia of the pancreas with diffuse lymph-node involvement.
abstract: We report a case of malakoplakia involving the pancreas in a 74-year-old man with associated regional lymphoadenopathy. Histological examination of both pancreas and lymph nodes revealed a diffuse histiocytic infiltrate containing numerous Michaelis-Gutmann bodies. Electron microscopy supported the diagnosis of malakoplakia and showed bacterial-like structures. Differential diagnosis includes myofibroblastic inflammatory tumor and histiocytic neoplasms. Lymph-node involvement during malakoplakia is extremely rare and it has never been documented microscopically. Lymphohematogenous spread of bacteria may be the cause of the nodal involvement, which, however, does not appear to influence the clinical course of the disease.
authors.affiliation: Università degli Studi di Milano, Servizio di Anatomia Patologica. Azienda Ospedaliera S.Paolo Via A. di Rudini 8, 20142 Milano, Italy. paolonuciforo@hotmail.com
authors.forename: Paolo Giovanni
authors.initials: PG
authors.lastname: Nuciforo
authors.forename: Laura
authors.initials: L
authors.lastname: Moneghini
authors.forename: Paola
authors.initials: P
authors.lastname: Braidotti
authors.forename: Laura
authors.initials: L
authors.lastname: Castoldi
authors.forename: Paolo
authors.initials: P
authors.lastname: De Rai
authors.forename: Silvano
authors.initials: S
authors.lastname: Bosari
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006104:Granuloma, Plasma Cell / Q000473:pathology; D054747:Histiocytic Sarcoma / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008287:Malacoplakia / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010180:Pancreatectomy; D010182:Pancreatic Diseases / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome