Vesical Malacoplakiaの超微細構造およびMichaelis-Gutmann小体の形成機序について

Abstract

Vesical malacoplakia is a disease reported for the first experience by Michaelis and Gutmann in 1902 and given the name by von Hansemann the next year, 1903. This disease is specific in that calcium-stain positive granules (Michaelis-Gutmann bodies, hereinafter abbreviated as M-G) in the histiocytes, and granuloma is produced. It is a noteworthy tendency that malacoplakia has been proved to occur not only in the bladder but also in other organs and tissues. In urological field, it has been reported to occur in the pelvis of the kidney, urinary tract, testis, epididymis, and prostate. It also has been reported to cause xanthogranulomatous pyelonephritis. The author made an endoscopic observation on the 2 female patients (71-year old and 57-year old) with cystitis-like symptoms, diagnosed as vesical malacoplakia, and conducted biopsy via urethra. The biopsy specimens were studied by histopathological, histochemical, and electron microscopical observations. Further, studies were conducted for elucidation of a cause of malacoplakia and the formation mechanism of M-G bodies. The results revealed bacteria in the histiocytes and M-G bodies in relation of E. coli infections, as well as the fact that M-G bodies were formed in phagolysosome by deposition of calcium phosphate and ferrum.