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Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report

Background: Isolated malakoplakia of the prostate is a rare inflammatory condition that has been clinically mistaken for prostatic malignancies. The development of Prostate Imaging Reporting and Data System (PI-RADS) classifications, and Prostate Health Index (PHI) has led to more accurate diagnosis...

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Autores principales: Heah, Nathaniel H., Tan, Teck Wei, Tan, Yung Khan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515101/
https://www.ncbi.nlm.nih.gov/pubmed/28736746
http://dx.doi.org/10.1089/cren.2017.0030
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author Heah, Nathaniel H.
Tan, Teck Wei
Tan, Yung Khan
author_facet Heah, Nathaniel H.
Tan, Teck Wei
Tan, Yung Khan
author_sort Heah, Nathaniel H.
collection PubMed
description Background: Isolated malakoplakia of the prostate is a rare inflammatory condition that has been clinically mistaken for prostatic malignancies. The development of Prostate Imaging Reporting and Data System (PI-RADS) classifications, and Prostate Health Index (PHI) has led to more accurate diagnosis of clinically significant disease and stratification of patients that may be at risk of prostate cancer. Case Presentation: We present a case of a 75-year-old male who was on follow-up with our hospital for elevated prostate specific antigen (PSA). He was admitted for an episode of urosepsis, which was treated with antibiotics and subsequently underwent further workup and was found to have a raised PHI, as well as a high PI-RADS classification and was later found to have malakoplakia based on histology of prostate tissue obtained during targeted magnetic resonance imaging (MRI)-guided fusion prostate biopsy. Conclusion: To our understanding, this is the first case where a prostate lesion has been labeled as a PI-RADS 5 lesion, with elevated PHI that has subsequently been proven histologically to be malakoplakia. An important possible confounder is the interval between the MRI and the episode of urosepsis and it is well known that urosepsis can affect the PSA and MRI result. We present this case to highlight the potential for a false diagnosis of prostate cancer, in spite of laboratory and radiological findings.
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spelling pubmed-55151012017-07-21 Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report Heah, Nathaniel H. Tan, Teck Wei Tan, Yung Khan J Endourol Case Rep Case Report Background: Isolated malakoplakia of the prostate is a rare inflammatory condition that has been clinically mistaken for prostatic malignancies. The development of Prostate Imaging Reporting and Data System (PI-RADS) classifications, and Prostate Health Index (PHI) has led to more accurate diagnosis of clinically significant disease and stratification of patients that may be at risk of prostate cancer. Case Presentation: We present a case of a 75-year-old male who was on follow-up with our hospital for elevated prostate specific antigen (PSA). He was admitted for an episode of urosepsis, which was treated with antibiotics and subsequently underwent further workup and was found to have a raised PHI, as well as a high PI-RADS classification and was later found to have malakoplakia based on histology of prostate tissue obtained during targeted magnetic resonance imaging (MRI)-guided fusion prostate biopsy. Conclusion: To our understanding, this is the first case where a prostate lesion has been labeled as a PI-RADS 5 lesion, with elevated PHI that has subsequently been proven histologically to be malakoplakia. An important possible confounder is the interval between the MRI and the episode of urosepsis and it is well known that urosepsis can affect the PSA and MRI result. We present this case to highlight the potential for a false diagnosis of prostate cancer, in spite of laboratory and radiological findings. Mary Ann Liebert, Inc. 2017-06-01 /pmc/articles/PMC5515101/ /pubmed/28736746 http://dx.doi.org/10.1089/cren.2017.0030 Text en © Nathaniel H. Heah et al. 2017; Published by Mary Ann Liebert, Inc. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Heah, Nathaniel H.
Tan, Teck Wei
Tan, Yung Khan
Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report
title Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report
title_full Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report
title_fullStr Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report
title_full_unstemmed Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report
title_short Malakoplakia of the Prostate as a Mimicker of Prostate Cancer on Prostate Health Index and Magnetic Resonance Imaging–Fusion Prostate Biopsy: A Case Report
title_sort malakoplakia of the prostate as a mimicker of prostate cancer on prostate health index and magnetic resonance imaging–fusion prostate biopsy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5515101/
https://www.ncbi.nlm.nih.gov/pubmed/28736746
http://dx.doi.org/10.1089/cren.2017.0030
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