Luis D. Nuño-Uscanga, Servicio de Urología, Centro Médico ABC, Ciudad de México, México
José B. Cisneros-Madrid, Servicio de Urología, Centro Médico ABC; Servicio de Urología, Hospital Ángeles Lomas; Ciudad de México, México
Alejandro Madero-Arteaga, Servicio de Urología, Centro Médico ABC; Servicio de Urología, Hospital Ángeles Lomas; Ciudad de México, México
José P. Lomelín-Ramos, Servicio de Urología, Centro Médico ABC; Servicio de Urología, Hospital Ángeles Lomas; Ciudad de México, México
Yeni Fernández de Lara-Barrera, Servicio de Radiología, Centro Médico ABC; Servicio de Radiología, CT Scanner Lomas Altas; Ciudad de México, México
Danny R. Soria-Céspedes, Servicio de Patología, Centro Médico ABC, Ciudad de México, México
Brandon Martínez-Torres, Servicio de Urología, Centro Médico ABC, Ciudad de México, México
Juan P. López-Calderón, Servicio de Urología, Centro Médico ABC, Ciudad de México, México
Malacoplakia has a special affinity for the urinary tract, almost all cases in the bladder and approximately 80-90% have positive cultures for Gram-negative organisms, most patients have some degree of immunocompromise, it is important to take this into account in patients with these characteristics even when extension studies imply another pathology. The percentage of false positives in prostate biopsies of lesions categorized as PI-RADS (Prostate Imaging-Report and Data System) 5 is not negligible, however, it is not common to find it as a differential diagnosis. A 69-year-old patient without immunocompromise, who initially presented acute urinary retention and elevated prostate specific antigen (8.35 ng/ml), complicated with urinary septic shock. Multiparametric magnetic resonance identified a prostatic abscess associated with a PI-RADS 5 lesion in peripheral prostatic zone, which was biopsied, with histopathological diagnosis of malacoplakia. It is a rare granulomatous pathology, it can occur in any part of the body, however, the first time that the prostatic location was described was in 1959 by Carruthers. Knowledge and suspicion of a rare, benign, inflammatory entity such as prostatic malacoplakia, even in the context of a non-immunocompromised patient, with a lesion characterized as PI-RADS 5, can prevent misdiagnosis and overtreatment of these patients.
Keywords: Malakoplakia. Prostate. Multiparametric magnetic resonance. Prostatic abscess. Michaelis-Gutmann. PI-RADS 5.