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Case 137. E. coli-induced epididymitis (67 y-o M)
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| Surgical resection for left epididymal tumor provoking active inflammatory response |
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Key words : E. coli, epididymitis, xanthogranuloma, malakoplakia
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| The epididymal tissue has been destroyed by abscess formation (HE). | Xanthogranulomatous change is observed at the periphery of the abscess lesion. No epithelial structure remains any longer (HE). | |
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| E. coli antigens (lipopolysaccharides) are demonstrated in the cytoplasm of foamy cells (immunostaining). Infection by Gram-negative enteric bacteria is indicated. | Ultrastructurally, positivity of E. coli antigens in the xanthogranulomatous foamy cell corresponds to rod-like pathogens (pre-embedding immunoelectron microscopy using a paraffin section). | |
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| Reference case 137A Malakoplakia of prostate (77 y-o M). Needle biopsy shows diffuse foamy cell infiltration. A few Michaelis-Guttmann bodies are discerned (HE). Differential diagnosis from poorly differentiated adenocarcinoma is needed. Malakoplakia and xanthogranulomatous inflammation are closely related each other. |
Reference case 137A Localization of E. coli antigens in the cytoplasm of foamy cells and Michaelis-Guttmann bodies (immunostaining). Immunostaining for E. coli antigens (LPS) using a DakoCytomation's commercial antiserum is valuable not only to confirm the diagnosis but also to clarify the etiology of the lesion. |
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