-
Dermatology Online Journal Jun 2019Malacoplakia is a rare acquired, infection-related granulomatous disorder, that may affect many systems, but typically occurs in the urinary tract. Cutaneous involvement... (Review)
Review
BACKGROUND
Malacoplakia is a rare acquired, infection-related granulomatous disorder, that may affect many systems, but typically occurs in the urinary tract. Cutaneous involvement is less prevalent, and most commonly presents with a perianal or genital region localization. Cutaneous malacoplakia is believed to be caused by an acquired bactericidal defect of macrophages in the setting of chronic infections and immunocompromised states. A diagnosis of cutaneous malacoplakia should be considered when encountering non-specific granulomatous lesions that are refractory to treatment. Histologic findings are marked by the presence of foamy macrophages containing the pathognomonic Michaelis-Gutman bodies.
OBJECTIVES
The aim of this review is to discuss the current perspectives on the pathophysiology, clinical features, diagnosis, and treatment of this disease. We would also like to emphasize that the integration of clinical information, microscopic findings, and exclusion of other cutaneous granulomatous processes is necessary to accurately diagnose this exceedingly rare disease and provide opportunity for therapeutic intervention.
PATIENTS/METHODS
Data for this work were collected from the published literature and textbooks.
RESULTS
Combined surgical excision and protracted antibiotic courses appear to have the highest success rate. Antibiotics should be culture specific, but drugs that easily permeate the macrophages appear to be the best choice.
Topics: Anti-Bacterial Agents; Dermatologic Surgical Procedures; Granuloma; Humans; Macrophages; Malacoplakia; Phagocyte Bactericidal Dysfunction; Skin Diseases, Bacterial
PubMed: 31329385
DOI: No ID Found -
International Journal of Dermatology Aug 1994
Review
Topics: Adolescent; Adult; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Infant; Malacoplakia; Male; Middle Aged; Skin Diseases
PubMed: 7960344
DOI: 10.1111/j.1365-4362.1994.tb02888.x -
BJU International Sep 1999
Review
Topics: Female; Female Urogenital Diseases; History, 20th Century; Humans; Malacoplakia; Male; Male Urogenital Diseases
PubMed: 10468763
DOI: 10.1046/j.1464-410x.1999.00198.x -
Scandinavian Journal of Urology and... 1993Testicular malacoplakia presenting as painless enlargement of the testis in a 23-year-old man is described. The literature is reviewed. (Review)
Review
Testicular malacoplakia presenting as painless enlargement of the testis in a 23-year-old man is described. The literature is reviewed.
Topics: Adult; Humans; Malacoplakia; Male; Testicular Diseases; Testis
PubMed: 8159934
DOI: 10.3109/00365599309182297 -
American Journal of Kidney Diseases :... Aug 1993Renal malacoplakia is an unusual form of chronic tubulointerstitial nephritis with a predilection for patients with recurrent urinary tract infections and an... (Review)
Review
Renal malacoplakia is an unusual form of chronic tubulointerstitial nephritis with a predilection for patients with recurrent urinary tract infections and an immunocompromised state. Its characteristic feature is the parenchymal infiltration by macrophages with ample cytoplasm containing abundant periodic acid-Schiff-positive granules, known as von Hansemann cells, and the presence of diagnostic extracytoplasmic or intracytoplasmic calcospherites, known as Michaelis-Gutmann bodies. Renal malacoplakia is more common in women (female to male ratio 3:1), in whom the lesions develop in a younger age group (third to fifth decade) than in men (over 50 years). Enlarged kidneys in the presence of persistent urinary infection should lead to the consideration of this entity. The diagnosis can only be established by pathologic examination of renal tissue. Renal biopsy early in the course of the disease is essential since in an increasing number of cases medical therapy has resulted in resolution of the disease process and preservation of renal function.
Topics: Female; Humans; Malacoplakia; Middle Aged; Nephritis, Interstitial
PubMed: 8352248
DOI: 10.1016/s0272-6386(12)70313-x -
Panminerva Medica Jun 2002Our aim is to present a singular case of malacoplakia of the tongue and a review of the literature. Malacoplakia (from the Greek "malacos", soft, and "placos", plaque)... (Review)
Review
Our aim is to present a singular case of malacoplakia of the tongue and a review of the literature. Malacoplakia (from the Greek "malacos", soft, and "placos", plaque) is a granulomatosis initially described in 1902. It has the clinical aspect of a yellow-brown, soft plaque of variable size, characterized by a central navel or ulcer and an intense peripheral hyperaemia, usually located in the urogenital and gastrointestinal tract. The mortality rate is higher than 50% if vital organs are involved. In the world literature there are 16 cases of the head and neck region and particularly only 2 of them are located on the tongue. In these 2 cases the lesion caused some distress to the patients who referred to a medical observation for this motive. Conversely we report a case of asymptomatic lingual malacoplakia occurring in a 57-year-old woman, diagnosed by chance during a stomatological examination in the Department of Oral Medicine and Periodontology of Turin University. In this case the outcome was quite plain and our patient did not need any supporting medical therapy. Nevertheless the potential danger of malacoplakia should underline the importance of a more careful histological assessment of submucosal nodules of the oro-pharyngeal region. Moreover the histopathological characteristic, the present etiopathogenetic hypothesis and the therapeutic pattern of malacoplakia suggested in the literature are discussed.
Topics: Female; Humans; Malacoplakia; Middle Aged; Tongue Diseases
PubMed: 12032438
DOI: No ID Found -
The Journal of Urology Feb 1981
Review
Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Chediak-Higashi Syndrome; Child; Child, Preschool; Diagnosis, Differential; Escherichia coli Infections; Female; Gastrointestinal Diseases; Humans; Infant; Malacoplakia; Male; Middle Aged; Prostatic Diseases; Urinary Bladder Diseases; Urinary Tract Infections; Urologic Diseases
PubMed: 7009885
DOI: 10.1016/s0022-5347(17)54940-x -
Urologia Internationalis 1995A 65-year-old diabetic man presented with a painful swelling of his right epididymis. Urine culture was sterile. Semicastration was performed and histology revealed... (Review)
Review
A 65-year-old diabetic man presented with a painful swelling of his right epididymis. Urine culture was sterile. Semicastration was performed and histology revealed malacoplakia of the epididymis without involvement of the testis. Histologic workup demonstrated typical von Hansemann cells and Michaelis-Gutmann bodies stained by von Kossa's stain. This is the 19th case of epididymal malacoplakia and the 9th case of epididymal malacoplakia without concurrent involvement of the testis. Literature review shows that the present case is typical with respect to the clinical presentation and with regard to the age of presentation. The fact that this patient was suffering from diabetes mellitus lends some support to the assumption that a compromised immune status could be etiologic in malacoplakia.
Topics: Aged; Diabetes Mellitus, Type 1; Epididymis; Humans; Malacoplakia; Male; Testicular Diseases
PubMed: 8588271
DOI: 10.1159/000282792 -
Chest Feb 1994Malacoplakia is a rare granulomatous disease well described in the urinary tract but which rarely involves the lung. We report for the first time, to our knowledge,...
Malacoplakia is a rare granulomatous disease well described in the urinary tract but which rarely involves the lung. We report for the first time, to our knowledge, tracheal localization of this unusual disorder. The larynx and probably kidneys were also involved. Differential diagnosis, physiopathology, and treatments are discussed.
Topics: Adult; Escherichia coli Infections; Female; Humans; Malacoplakia; Mycobacterium avium-intracellulare Infection; Pneumonia; Tracheal Diseases
PubMed: 8306775
DOI: 10.1378/chest.105.2.608 -
American Journal of Otolaryngology 2009Extra-urogenital tract malacoplakia is uncommon, with tongue malacoplakia being exceptionally rare. The nonspecific clinical presentation and variable histologic... (Review)
Review
BACKGROUND
Extra-urogenital tract malacoplakia is uncommon, with tongue malacoplakia being exceptionally rare. The nonspecific clinical presentation and variable histologic patterns can make recognition of this lesion and separation from other lesions challenging. There are only a few reported cases in the English literature.
MATERIALS AND METHODS
Five case reports of tongue malacoplakia were compiled from the literature (MedLine 1960-2008) and integrated with this case report.
RESULTS
The patients included 4 males and 2 females, ranging in age from 9 to 98 years (mean, 64 years). Patients presented with difficulty swallowing, foreign body sensation, a mass lesion, or referred pain (neck or ear). Symptoms were present from a few days up to 18 months. The base of the tongue was the most frequent site, although midline tongue and half of the tongue were also affected. Radiographic studies demonstrated a mass, with a single lesion showing positron emission tomography positivity. Two patients had previous cancers (prostate and colorectal; larynx). This case report was a farm hand for horses, with gram-negative rods, suggestive of Rhodococcus equi identified. The lesions were 1 to 2 cm in greatest dimension. Histologically, there is pseudoepitheliomatous hyperplasia or ulceration with a heavy acute and chronic inflammatory infiltrate. The subepithelial spaces are completely filled with eosinophilic histiocytes, most of which contain granular material in their cytoplasm. Well-formed, blue, calcific bodies are noted, a few showing a "targetoid appearance" and concentric lamination. These Michaelis-Gutmann bodies are positive with von Kossa, iron, and periodic acid-Schiff stains. These findings support a diagnosis of malacoplakia. The differential diagnosis includes granular cell tumor, poorly differentiated carcinoma, and Langerhans histiocytosis. Patients are managed with antibiotic therapy and excision.
CONCLUSIONS
Tongue malacoplakia is rare, often presenting as a mass lesion. Histologic recognition of this abnormal phagocytic disorder will prevent potentially disfiguring surgery.
Topics: Aged; Aged, 80 and over; Child; Female; Humans; Malacoplakia; Male; Middle Aged; Tongue Diseases
PubMed: 19239951
DOI: 10.1016/j.amjoto.2008.02.014