-
Pathogens (Basel, Switzerland) Mar 2021Malacoplakia is an uncommon chronic granulomatous inflammation that rarely affects the female genital tract. A case of a 78-year-old woman with malacoplakia involving...
Malacoplakia is an uncommon chronic granulomatous inflammation that rarely affects the female genital tract. A case of a 78-year-old woman with malacoplakia involving the uterine cervix and the vagina is described. The patient complained of vaginal bleeding. Clinically, a 13-mm mass was detected in the cervix, which was confirmed by ultrasound scan and magnetic resonance imaging. Histological examination showed a dense histiocytic infiltrate with abundant Michaelis-Gutmann bodies involving the uterine cervix and the upper vagina. The presence of was confirmed in the lesion by immunohistochemistry and polymerase chain reaction. Only 12 cases of cervical malacoplakia have been reported to date. This condition should be included in the differential diagnosis of cervical tumors.
PubMed: 33804212
DOI: 10.3390/pathogens10030343 -
Journal of Cutaneous Pathology Jul 2021
Topics: Aged; Allografts; Anal Canal; Escherichia coli Infections; Humans; Immunocompromised Host; Malacoplakia; Male; Myelodysplastic Syndromes; Skin Ulcer; Stem Cell Transplantation; Transplant Recipients
PubMed: 33470456
DOI: 10.1111/cup.13761 -
Indian Journal of Urology : IJU :... 2020Malacoplakia is an inflammatory lesion which can affect any organ in the body but predominantly affects the genitourinary system and mainly the bladder. Malacoplakia of...
Malacoplakia is an inflammatory lesion which can affect any organ in the body but predominantly affects the genitourinary system and mainly the bladder. Malacoplakia of the bladder has variable presentations and is associated with urinary infection or immunosuppression. Mullerianosis of the bladder is a rare lesion that consists of two out of the three tissues, endometriosis, endocervicosis, or endosalpingiosis. It is usually associated with a previous cesarean section or pelvic surgery. The diagnosis is confirmed on histopathological examination. Malacoplakia and mullerianosis are usually isolated lesions of the bladder. We present a unique case of coexistence of malacoplakia and mullerianosis in the urinary bladder, reported for the first time in the literature.
PubMed: 33376273
DOI: 10.4103/iju.IJU_134_20 -
Diagnostic Pathology Jul 2020Malakoplakia is an uncommon, tumor-like inflammatory disease characterized by impaired histiocytes that are unable to completely digest phagocytized bacteria. The...
BACKGROUND
Malakoplakia is an uncommon, tumor-like inflammatory disease characterized by impaired histiocytes that are unable to completely digest phagocytized bacteria. The genitourinary tract is the most common site of involvement, however, cases have also been described in the gastrointestinal tract, suggesting that it is the second most common site of involvement. This study investigates the clinical and histologic features of malakoplakia in the gastrointestinal tract.
CASE PRESENTATION
For 23 gastrointestinal specimens (biopsies and resections) from patients with a pathologic diagnosis of malakoplakia, we recorded the gender, age, location, primary diagnosis, endoscopic or surgical indication, endoscopic/gross impression and immune status (immunocompromised vs. immunocompetent).
CONCLUSION
Malakoplakia occurred throughout the length of the gastrointestinal tract with most of the cases located in the sigmoid colon and rectum (n = 10); other sites included the transverse and descending colon (n = 4), stomach/gastroesophageal junction (n = 4), appendix (n = 2), cecum (n = 1), small bowel (n = 1), and the peri-anal area (n = 1). Endoscopically, these lesions most commonly appeared as polyps (n = 10) or masses (n = 5), other clinical endoscopic impressions varied from a thickened area/fibrosis to mucosal erythema. Most patients were immunocompromised due to a disease state (e.g. organ transplantation, cancer diagnosis, autoimmune condition) and/or medication effect. Eight patients with malakoplakia were on immunosuppressive medications (8/23, 35%). Common immunosuppressed disease states included cancer (n = 9), autoimmune disease (n = 5), status post organ transplantation (n = 4), diabetes (n = 5), infection/sepsis (n = 3), and HIV/AIDS (n = 1). Some patients had multiple co-morbidities (i.e. diabetes and organ transplant). Twenty-one patients with malakoplakia were in an immunosuppressive state (21/23, 91%).
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Child; Child, Preschool; Female; Gastrointestinal Tract; Humans; Immunocompromised Host; Immunosuppressive Agents; Malacoplakia; Male; Middle Aged; Rectum; Young Adult
PubMed: 32709245
DOI: 10.1186/s13000-020-01013-y -
Diagnostic Pathology Jul 2020Malacoplakia is a rare chronic inflammatory disease. The name derives from the Greek "μαλακός" meaning "soft" and "πλάξ" meaning "plaque", describing its...
BACKGROUND
Malacoplakia is a rare chronic inflammatory disease. The name derives from the Greek "μαλακός" meaning "soft" and "πλάξ" meaning "plaque", describing its usual macroscopic presentation as a friable yellow soft plaque. It was first described by von Hansemann in 1901 and by Michaelis and Gutmann in 1902. The urinary system is the most commonly involved site. Female genital tract involvement is extremely rare. Treatment is prevalently based on antibiotics with surgical intervention sometimes necessary. Prognosis is usually good, but relapse may frequently occur.
CASE PRESENTATION
This report illustrates the first case of endometrial malacoplakia in a 40 years-old patient who received endometrial curettage due to the retention of placental rests following an abortion. After conspicuous vaginal sero-hematic secretions, the patient received a further curettage. The histological examination did not show any retention of chorionic rests, but an endometrial and myometrial infiltration of histiocytes with large granular cytoplasm within a chronic inflammatory background. Immunoreactivity for CK-pool was negative, while CD68 immunostaining was strongly positive.
CONCLUSIONS
Malacoplakia of endometrium is an extremely rare condition, with few cases reported in the whole international literature. In this paper, we present the first case associated to an abortion followed by endometrial curettage procedures. This rare disease should always be attentively examined, considering, among differential diagnoses, uterine neoplasms or physiological conditions such as cumulus of foamy macrophages in the endometrium.
Topics: Abortion, Induced; Adult; Dilatation and Curettage; Endometrium; Female; Humans; Malacoplakia; Pregnancy
PubMed: 32682433
DOI: 10.1186/s13000-020-01014-x -
Medicine Jun 2020Either malacoplakia or xanthogranulomatous cystitis (XC) is a rare chronic infection disease of urinary bladder, which often mimics bladder masses undifferentiated from...
RATIONALE
Either malacoplakia or xanthogranulomatous cystitis (XC) is a rare chronic infection disease of urinary bladder, which often mimics bladder masses undifferentiated from malignance and results in severe lower urinary tract symptoms. The malacoplakia combined with XC is even rarer in the literature.
PATIENT CONCERNS
A 64-year-old female, who presented with nocturia, frequency of micturition, severe urgency with occasional urinary incontinence, and recurrent hematuria for >2 years, was diagnosed with azotemia and anemia. In addition, two 1.0 × 1.0 cm masses of bladder were detected by computer tomography.
DIAGNOSES
Malacoplakia combined with xanthogranulomas cystitis was diagnosed histologically. Video urodynamic test showed poor bladder compliance (9 mL/comH2O), markedly decreased maximum bladder capacity (120 mL), and right vesicoureteral reflux at a low intravesical pressure level (25 cmH2O).
INTERVENTIONS
Transurethral resection of bladder masses was carried out after treatment of urinary infection by intravenous piperacillin-tazobactam. Oral Ciprofloxacin and Tolterodine were postoperatively used to prevent recurrent lower urinary tract infections and alleviate detrusor overactivity.
OUTCOMES
The treatment did not alleviate azotemia, frequency, urgency with incontinence, and bilateral hydroureteronephrosis, but the patient refused to undergo bladder augmentation on account of her poor economic status.
LESSONS
Malacoplakia or/and xanthogranulomas cystitis may lead to poor bladder compliance and video urodynamic study should be considered in patients with refractory chronic lower urinary tract symptoms.
Topics: Cystitis; Female; Humans; Malacoplakia; Middle Aged; Nocturia; Tomography, X-Ray Computed; Urinary Bladder; Urinary Incontinence; Urinary Tract Infections
PubMed: 32590783
DOI: 10.1097/MD.0000000000020852 -
Folia Medica Cracoviensia 2019Malakoplakia is regarded as a chronic granulomatous inflammatory disease with a good prognosis. It usually affects the urinary system, especially the urinary bladder....
Malakoplakia is regarded as a chronic granulomatous inflammatory disease with a good prognosis. It usually affects the urinary system, especially the urinary bladder. Bacterial infections, including E. coli are thought to be the main factor in pathogenesis. It frequently coexists with chronic diseases and immunosuppression state. Histopathological examination of affected tissue samples is thought to be the best diagnostic method. The basic microscopic feature is mixed inflammatory infiltration containing foamy histiocytes known as von Hansemann cells, frequently with basophilic inclusions known as Michaelis-Gutmann bodies. Symptoms and the clinical course of malakoplakia depend on location and the extent of the lesions. The lesion is treated successfully with antibiotic therapy and surgical excision.
Topics: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Female; Humans; Malacoplakia; Male; Middle Aged; Urinary Bladder; Urinary Tract
PubMed: 31659350
DOI: No ID Found -
Canadian Association of Radiologists... Nov 2019To review the computed tomography and magnetic resonance imaging manifestations of acute and chronic renal infections that may mimic malignancy and to provide useful... (Review)
Review
PURPOSE
To review the computed tomography and magnetic resonance imaging manifestations of acute and chronic renal infections that may mimic malignancy and to provide useful tips to establish an imaging diagnosis.
CONCLUSION
Acute and chronic bacterial pyelonephritis are usually readily diagnosed clinically and on imaging when the diagnosis is suspected based upon clinical presentation. When unsuspected, focal, extensive or mass-like, acute and chronic bacterial pyelonephritis may mimic infiltrative tumours such as urothelial cell carcinoma (UCC), lymphoma, and metastatic disease. Infection may be suspected when patients are young and otherwise healthy when there is marked associated perinephric changes and in the absence of metastatic adenopathy or disease elsewhere in the abdomen and pelvis. Renal abscesses, from bacterial or atypical microbial agents, can appear as complex cystic renal masses mimicking cystic renal cell carcinoma. Associated inflammatory changes in and around the kidney and local invasion favour infection. Emphysematous pyelonephritis can mimic necrotic or fistulizing tumour; however, infection is more likely and should always be considered first. Xanthogranulomatous pyelonephritis can mimic malignancy when focal or multifocal and in cases without associated renal calculi. Malacoplakia is an inflammatory process that may mimic malignancy and should be considered in patients with chronic infection. Bacillus Calmette-Guerin (BCG)-induced pyelonephritis is rare but can mimic renal malignancy and should be considered in patients presenting with a renal mass when being treated with BCG for urinary bladder UCC.
Topics: Acute Disease; Chronic Disease; Diagnosis, Differential; Humans; Kidney Neoplasms; Magnetic Resonance Imaging; Pyelonephritis; Tomography, X-Ray Computed
PubMed: 31537315
DOI: 10.1016/j.carj.2019.07.002 -
Journal of Gastrointestinal and Liver... Sep 2019
Topics: Anemia, Iron-Deficiency; Anemia, Macrocytic; Cecal Diseases; Esophageal and Gastric Varices; Gastrointestinal Hemorrhage; Humans; Liver Cirrhosis, Alcoholic; Malacoplakia; Male; Middle Aged; Treatment Outcome
PubMed: 31517320
DOI: 10.15403/jgld-418 -
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