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Clinicopathologic Features of Genitourinary Malakoplakia and Analytical Utility of the MetaPath Assay.

Infection and drug resistance 2026 Vol.19() p. 582917

He L, Li F

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[PURPOSE] To describe the clinicopathological spectrum of genitourinary malakoplakia (MPL) and to evaluate the feasibility and clinical impact of metagenomic pathogen detection (MetaPath) performed on

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BibTeX ↓ RIS ↓
APA He L, Li F (2026). Clinicopathologic Features of Genitourinary Malakoplakia and Analytical Utility of the MetaPath Assay.. Infection and drug resistance, 19, 582917. https://doi.org/10.2147/IDR.S582917
MLA He L, et al.. "Clinicopathologic Features of Genitourinary Malakoplakia and Analytical Utility of the MetaPath Assay.." Infection and drug resistance, vol. 19, 2026, pp. 582917.
PMID 41710374
DOI 10.2147/IDR.S582917

Abstract

[PURPOSE] To describe the clinicopathological spectrum of genitourinary malakoplakia (MPL) and to evaluate the feasibility and clinical impact of metagenomic pathogen detection (MetaPath) performed on archival formalin-fixed paraffin-embedded (FFPE) tissue.

[PATIENTS AND METHODS] Clinical imaging, histopathology, immunohistochemistry, special stains and MetaPath results were retrospectively analysed in five MPL cases diagnosed between January 2019 and August 2025.

[RESULTS] The cohort comprised four men and one woman with a median age of 65.4 years. Four lesions arose in the prostate and one in the bladder. Histology showed chronic granulomatous inflammation with numerous eosinophilic histiocytes containing 5-10 µm targetoid Michaelis-Gutmann bodies. CD68 and CD163 were diffusely positive; PAS and iron stains highlighted the inclusions. MetaPath identified pathogens in 3/5 (60%) FFPE specimens ( in two, in one). Antibiotic regimens were adjusted according to MetaPath results. After a median follow-up of 6 months (range 4-8) all patients remained symptom-free.

[CONCLUSION] MPL is frequently misdiagnosed as malignancy. MetaPath can reliably detect pathogens in archival tissue and guide targeted antimicrobial therapy, representing a valuable adjunct to conventional culture.

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