1995 Volume 34 Issue 4 Pages 704-711
A case of malakoplakia (Mp) found in both the urinary bladder and the left renal pelvis of a 51-year-old female is reported. This combination of tissues is very rare in the literature. The Mp lesion in both tissues showed the same histology. Touch smears and specimens for electron microscopy were obtained from a surgically resected specimen of the renal pelvic Mp lesion. Cells with Michaelis-Gutmann bodies (M-G body) could not be observed on 2 occasions in the urinary sediment cytology. In the touch preparations of the Mp lesion, many histiocytes contained 1 or 2 pieces of laminated M-G body which resembled the eye of an owl or a target, and measured 3.5 to 7.0 μm in diameter. In addition to the M-G bodies, many smaller round bodies less than 2μm in diameter which did not show the laminated stfucture were observed in the cytoplasm. Immunohistochemistry for α1-antichymotrypsin in the histological section revealed many positive granules in the cytoplasm which corresponded to phagolysosomes (Pl). The M-G bodies were also positively stained. The M-G bodies were observed electron-microscopically, and were comprised of electron-dense cores with needle-like crystals and homogeneous, less dense peripheral zones. In addition to the M-G bodies, many Pl were observed in the cytoplasm of histiocytes, and two types of Pl were recognized. In the M-G bodies, finger print-like laminated structures, which had been observed in Pl, were also found. This may suggest that the M-G bodies are derived from Pl, by fusion of the latter.
