Work

Clinicopathologic Features of Genitourinary Malakoplakia and Analytical Utility of the MetaPath Assay

Year: 2026

Type: article

Abstract: Purpose: To describe the clinicopathological spectrum of genitourinary malakoplakia (MPL) and to evaluate the feasibility and clinical impact of metagenomic pathogen detection (MetaPath) performed on archival formalin-fixed paraffin-embedded (FFPE) tissue. Patients and Methods: Clinical imaging, histopathology, immunohistochemistry, special stains and MetaPath results were retrospectively analysed in five MPL cases diagnosed between January 2019 and August 2025. Results: The cohort comprised four men and one woman with a median age of 65.4 years. Four lesions arose in the prostate and one in the bladder. Histology showed chronic granulomatous inflammation with numerous eosinophilic histiocytes containing 5– 10 μm targetoid Michaelis–Gutmann bodies. CD68 and CD163 were diffusely positive; PAS and iron stains highlighted the inclusions. MetaPath identified pathogens in 3/5 (60%) FFPE specimens ( Escherichia coli in two, Pseudomonas aeruginosa in one). Antibiotic regimens were adjusted according to MetaPath results. After a median follow-up of 6 months (range 4– 8) all patients remained symptom-free. Conclusion: MPL is frequently misdiagnosed as malignancy. MetaPath can reliably detect pathogens in archival tissue and guide targeted antimicrobial therapy, representing a valuable adjunct to conventional culture. Keywords: malakoplakia, Michaelis–Gutmann body, malakoplakia concurrent with prostate cancer, metagenomic pathogen detection technology, special stains

Source: Infection and Drug Resistance

DOI: 10.2147/idr.s582917

Authors: Lin He, Fen Li

Institutions: Sichuan University, West China Medical Center of Sichuan University, Chengdu Second People's Hospital

Language: English

Topic: Urinary and Genital Oncology Studies

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836