-
International Journal of Surgery Case... Nov 2023Malakoplakia is a rare inflammatory condition that generally occurs in immunocompromised individuals and is thought to be secondary to a bactericidal defect in...
INTRODUCTION AND IMPORTANCE
Malakoplakia is a rare inflammatory condition that generally occurs in immunocompromised individuals and is thought to be secondary to a bactericidal defect in macrophages.
CASE PRESENTATION
In this report, we present the case of a 50-year-old multiparous patient who presented with chronic pelvic pain. Ultrasonography revealed a suspicious left lateral-uterine mass. Laparoscopic exploration showed an inflammatory mass in the left adnexa adherent to the uterus, peritoneum, and meso-sigmoid. The patient underwent a total hysterectomy with bilateral salpingo-oophorectomy and peritoneal biopsy. Histological findings were consistent with a left adnexal location of malacopakia, and Bacteriological analysis revealed Escherichia coli infection sensitive to ciprofloxacin. At the 6-month follow-up, no recurrence was observed. The patient's condition improved following surgery and antibiotic treatment.
CLINICAL DISCUSSION
Genitourinary malakoplakia is more common in women and has no specific clinical, biological, or radiological features. Diagnosis is based on histological criteria, notably the presence of Michaelis-Gutmann bodies. Advances in our understanding of the pathophysiology of malakoplakia have made it possible to consider medical treatment options, mainly through the use of antibiotics. However, in cases where the organ is severely affected, surgical excision is recommended.
CONCLUSIONS
To summarize, adnexal malacoplakia is a highly uncommon disease that may be mistaken as a malignant tumor. The diagnosis is established through histological examination. The usual treatment is a combination of surgical excision followed by targeted antibiotic therapy, as the diagnosis is often not made until after surgery.
PubMed: 37939569
DOI: 10.1016/j.ijscr.2023.109012 -
Journal of Nephrology Dec 2023
Topics: Humans; Malacoplakia; Urinary Tract Infections; Acute Kidney Injury
PubMed: 37924475
DOI: 10.1007/s40620-023-01796-5 -
ANZ Journal of Surgery Feb 2024
Topics: Humans; Malacoplakia; Neoplasm Recurrence, Local; Pelvis; Proctectomy; Perineum; Rectal Neoplasms; Postoperative Complications
PubMed: 37915265
DOI: 10.1111/ans.18753 -
QJM : Monthly Journal of the... Mar 2024
Topics: Humans; Urinary Bladder; Malacoplakia; Urinary Bladder Diseases
PubMed: 37847659
DOI: 10.1093/qjmed/hcad241 -
Transplant Infectious Disease : An... Dec 2023
Topics: Humans; Kidney Transplantation; Malacoplakia; Anti-Bacterial Agents; Immunosuppression Therapy; Hydronephrosis
PubMed: 37787406
DOI: 10.1111/tid.14158 -
Cirugia Espanola Mar 2024
Topics: Humans; Mucocele; Diagnosis, Differential; Malacoplakia; Appendix; Cecal Diseases
PubMed: 37730119
DOI: 10.1016/j.cireng.2023.09.001 -
Clinical Nuclear Medicine Oct 2023A 56-year-old man presented with a 2-month history of a mass in the right epididymo-testicular region, which exhibited heterogeneous high avidity for 18F-FDG on PET/CT....
A 56-year-old man presented with a 2-month history of a mass in the right epididymo-testicular region, which exhibited heterogeneous high avidity for 18F-FDG on PET/CT. Malignant tumor was highly suspected, leading to subsequent right orchiectomy and epididymectomy. Histopathological examination revealed the presence of characteristic Michaelis-Gutmann bodies within von Hansemann macrophages, confirming the diagnosis of malacoplakia.
Topics: Male; Humans; Middle Aged; Fluorodeoxyglucose F18; Positron Emission Tomography Computed Tomography; Malacoplakia; Testis; Positron-Emission Tomography
PubMed: 37682619
DOI: 10.1097/RLU.0000000000004799 -
Clinical Nuclear Medicine Oct 2023Malacoplakia is a rare chronic granulomatous disease and frequently associated with Escherichia coli infection. We describe the contrast-enhanced CT and FDG PET/CT...
Malacoplakia is a rare chronic granulomatous disease and frequently associated with Escherichia coli infection. We describe the contrast-enhanced CT and FDG PET/CT findings in a case of bladder and ureteral malakoplakia with E. coli urinary tract infection. Contrast-enhanced CT showed multiple enhancing mural nodules in the bladder and left ureter, ranging from several millimeters to 3.1 cm. The ureteral nodules showed significantly increased FDG uptake with SUVmax of 20.4, due to histiocyte, lymphocyte, and plasma cell infiltrates revealed by histopathology.
Topics: Humans; Ureter; Fluorodeoxyglucose F18; Malacoplakia; Escherichia coli; Positron Emission Tomography Computed Tomography; Ureteral Neoplasms
PubMed: 37682609
DOI: 10.1097/RLU.0000000000004800 -
Journal of Comparative Pathology Aug 2023Malakoplakia is a rare chronic granulomatous disease usually affecting the urinary bladder and other locations. In humans, the gastrointestinal tract is the second most...
Malakoplakia is a rare chronic granulomatous disease usually affecting the urinary bladder and other locations. In humans, the gastrointestinal tract is the second most common location but there are no reports of intestinal malakoplakia in animals. A 10-month-old female French Bulldog was presented with chronic haemorrhagic diarrhoea and anorexia with normochromic-normocytic anaemia and hypoalbuminaemia. Grossly, there was mucosal thickening and ulceration of the caecum, colon and rectum. Microscopically, transmural sheets of foamy macrophages were seen in these tissues. Macrophages were periodic acid-Schiff, vimentin and ionized calcium-binding adaptor molecule 1 positive and contained von Kossa- and Prussian blue-positive Michaelis-Gutmann bodies. Giemsa staining revealed rod-shaped bacterial colonies and fluorescence in-situ hybridization demonstrated Escherichia coli within macrophages. This is the first reported case of intestinal malakoplakia in domestic animals. Pathological features of intestinal malakoplakia share many similarities with ulcerative histiocytic colitis in dogs but it is unclear if they are different forms of the same pathological process or distinct entities.
Topics: Humans; Animals; Dogs; Female; Malacoplakia; Intestines; Colitis, Ulcerative; Dog Diseases
PubMed: 37647838
DOI: 10.1016/j.jcpa.2023.07.002 -
Diagnostic Pathology Aug 2023Malakoplakia is a rare inflammatory disease of the urogenital tract. There have been no reports of malakoplakia expressing anaplastic lymphoma kinase (ALK) to date....
BACKGROUND
Malakoplakia is a rare inflammatory disease of the urogenital tract. There have been no reports of malakoplakia expressing anaplastic lymphoma kinase (ALK) to date. Here, we present one case of malakoplakia with aberrant ALK expression by immunohistochemistry and discuss the clinical significance.
CASE PRESENTATION
A 65-year-old Chinese woman with a history of diabetes presented with solid masses in the liver and kidney and elevated lesions on the mucosal surface of the colon. Right nephrectomy and partial liver resection were performed. Microscopically, sheets of histiocytes with poor intercellular adhesion were seen, with Michaelis-Gutmann bodies present in both the intracellular and extracellular interstitium. CD10-, CD68-, and CD163-positive cells were present, with Michaelis-Gutmann bodies confirmed by staining with Alcian blue, periodic acid-Schiff (PAS), periodic acid-Schiff with diastase, Von Kossa, and Prussian blue. Aberrant ALK1 and ALK (D5F3) expression was observed in the cytoplasm and nucleus of cells. However, ALK gene mutation was not detected by fluorescence in situ hybridization or whole exome next-generation sequencing. NGS revealed nine individual somatic gene mutations: GOT1L1, GLIS2, SPOUT1, TMEM97, MUC3A, NSD2, SFXN5, ADAD1 and RAD50. The significance of the somatic gene mutations detected in this study is not clear, and the relationship between them and malakoplakia cannot be clarified by existing scientific studies. The pathological diagnosis was malakoplakia with aberrant ALK expression by immunohistochemistry. The antibiotics imipenem and vancomycin were started based on the results of drug sensitivity analysis and the patient was subsequently discharged. She experienced no discomfort during 30 months of follow-up.
CONCLUSION
This is the first reported case of malakoplakia with aberrant ALK expression, it should be differentiated from ALK-positive histiocytosis to avoid misdiagnosis.
Topics: Female; Humans; Aged; Anaplastic Lymphoma Kinase; Immunohistochemistry; Malacoplakia; In Situ Hybridization, Fluorescence; Periodic Acid
PubMed: 37644531
DOI: 10.1186/s13000-023-01383-z