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Transplantation Proceedings 2022Malakoplakia is a rare pseudotumor that arises in the context of recurrent infections, particularly in immunocompromised states. We report a case of renal allograft...
INTRODUCTION
Malakoplakia is a rare pseudotumor that arises in the context of recurrent infections, particularly in immunocompromised states. We report a case of renal allograft parenchymal malakoplakia.
CASE REPORT
A 59-year-old woman successfully received a cadaveric renal transplant in June 2018. Two months after transplantation, she was treated for a urinary tract infection (UTI). In March 2019, she underwent allograft biopsy for increasing creatinine. The biopsy identified T cell mediated rejection and steroid pulse therapy was performed. In December 2019, she was hospitalized for right flank pain and pyuria, and her creatinine level was 1.9 mg/dL. Radiographic findings were suggestive of a hematoma or abscess in the perirenal area, and septated fluid collection was suspected. Biopsy results suggested malakoplakia, and von Kossa stain was positive for Michaelis- Gutmann bodies. Tissue culture demonstrated Escherichia coli, and this was treated with antibiotics. The dose of tacrolimus was reduced. The patient was discharged after 1 month of hospitalization and was maintained on oral antibiotics. Follow-up imaging revealed an increase in the extent of lesion into the adjacent abdominal wall. Assuming the case to be refractory, we performed surgical resection and abscess drainage. Although the renal parenchymal involvement persisted, the size showed a decreasing trend over 2 months of serial observation with ultrasonography.
CONCLUSIONS
Malakoplakia should be considered as a differential diagnosis for recurrent UTI with graft dysfunction. Malakoplakia can be successfully treated with reduction in immunosuppression and medical therapy using long-term antibiotic treatment in most cases. However, early surgical treatment must be considered for refractory cases.
Topics: Abscess; Anti-Bacterial Agents; Creatinine; Female; Humans; Kidney Transplantation; Malacoplakia; Middle Aged; Steroids; Tacrolimus; Urinary Tract Infections
PubMed: 35811147
DOI: 10.1016/j.transproceed.2022.03.055 -
Clinical Gastroenterology and... Dec 2022
Topics: Female; Humans; Malacoplakia; Immunocompromised Host; Bacterial Infections; Rectum; Colon
PubMed: 35811046
DOI: 10.1016/j.cgh.2022.06.004 -
Journal of Gastrointestinal Surgery :... Nov 2022
Topics: Humans; Malacoplakia; Colonic Neoplasms; Retroperitoneal Space; Colonic Diseases
PubMed: 35713763
DOI: 10.1007/s11605-022-05392-z -
Clinical and Experimental Dermatology Aug 2022Cutaneous malakoplakia (CM) is a rare, chronic, granulomatous disease characterized histopathologically by Michaelis-Gutmann bodies (MGB). Verruciform xanthoma (VX) is a...
Cutaneous malakoplakia (CM) is a rare, chronic, granulomatous disease characterized histopathologically by Michaelis-Gutmann bodies (MGB). Verruciform xanthoma (VX) is a rare, benign lesion characterized histopathologically by epithelial papillomatous hyperplasia, local hyperkeratosis with incomplete keratosis, infiltration of foam cells and inflammatory cells in the papillary dermis. We present an elderly Chinese man with CM and coexisting VX with histological confirmation of MGB.
Topics: Aged; Dermis; Humans; Keratosis; Malacoplakia; Male; Xanthomatosis
PubMed: 35357037
DOI: 10.1111/ced.15207 -
Nephrologie & Therapeutique Jun 2022Cutaneous malakoplakia is a rare pseudo-tumor that occurs in immunocompromised patients. It is a reaction to an infection caused by Gram negative bacteria. The clinical...
Cutaneous malakoplakia is a rare pseudo-tumor that occurs in immunocompromised patients. It is a reaction to an infection caused by Gram negative bacteria. The clinical presentation is nonspecific and the diagnosis is histological. The evolution is recurrent and the combination of a surgical treatment, antibiotics and adaptation of immunosuppressive therapy is necessary to cure the disease. The emergence of antibiotic resistance in bacteria responsible for the pathology can complicate the treatment and require additional microbial sampling. We report a case that occurred in a renal transplant patient with a complex diagnostic and therapeutic management.
Topics: Anti-Bacterial Agents; Humans; Immunocompromised Host; Kidney Transplantation; Malacoplakia; Neoplasms
PubMed: 35260345
DOI: 10.1016/j.nephro.2021.10.007 -
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke... Feb 2022
Topics: Humans; Malacoplakia; Palatine Tonsil
PubMed: 35196766
DOI: 10.3760/cma.j.cn115330-20210317-00134 -
Revista Espanola de Patologia :... 2022Malakoplakia is a chronic inflammatory process caused by a lysosomal defect in bacterial digestion. Although rare, it occurs more frequently in the genitourinary tract...
Malakoplakia is a chronic inflammatory process caused by a lysosomal defect in bacterial digestion. Although rare, it occurs more frequently in the genitourinary tract and in patients with immune dysfunction. The bladder is the most commonly affected site, although cases have been reported in other organs, including the prostate gland. Clinically, this lesion can be confused with malignant tumours, both on physical examination and imagining techniques. This is particularly pronounced in the prostate, making the differential diagnosis challenging. Histologically, characteristic aggregates of histiocytes with basophilic intracytoplasmic inclusions composed of calcium and iron salts are found. We present a case diagnosed on transrectal biopsy as acinar adenocarcinoma with a Gleason 5 + 5 = 10 score. Prostatectomy revealed an unusual association of diffuse prostate malakoplakia and an area of acinar adenocarcinoma with a Gleason score of 3 + 4 = 7.
Topics: Adenocarcinoma; Humans; Malacoplakia; Male; Neoplasm Grading; Prostate; Prostatectomy
PubMed: 34980441
DOI: 10.1016/j.patol.2019.06.002 -
Transplantation Proceedings 2022Lung nodules or masses due to a variety of malignant or benign conditions such as opportunistic infections are observed after lung transplant. Malakoplakia is a rare... (Review)
Review
Lung nodules or masses due to a variety of malignant or benign conditions such as opportunistic infections are observed after lung transplant. Malakoplakia is a rare complication in immunocompromised patients. Here we describe the clinical course and management of a lung transplant recipient with pulmonary malakoplakia and provide a review of the literature. To our knowledge, this is the first report of a case of pulmonary malakoplakia due to Escherichia coli infection in a lung allograft.
Topics: Escherichia coli Infections; Humans; Lung; Lung Transplantation; Malacoplakia; Transplant Recipients
PubMed: 34973840
DOI: 10.1016/j.transproceed.2021.11.013 -
Journal of the American Veterinary... Dec 2021A 4-month-old 5.9-kg sexually intact female French Bulldog was presented because of recurrent urinary tract infections in combination with pollakiuria, hematuria, and...
CASE DESCRIPTION
A 4-month-old 5.9-kg sexually intact female French Bulldog was presented because of recurrent urinary tract infections in combination with pollakiuria, hematuria, and urinary incontinence.
CLINICAL FINDINGS
A diagnosis of malakoplakia was made on the basis of results of hematologic and serum biochemical testing, abdominal ultrasonography, bacterial culture, and cystoscopic biopsies of the urinary bladder wall. Biopsy samples were sent for routine histologic examination and fluorescence in situ hybridization to confirm the presence of intracellular and subendothelial bacteria.
TREATMENT AND OUTCOME
Treatment with enrofloxacin was started after the diagnosis of malakoplakia was confirmed. During treatment, polypoid changes in the urinary bladder decreased dramatically but did not disappear. On follow-up ultrasonography after 12 weeks of treatment, marked improvement was visible and results of repeated bacterial culture and fluorescence in situ hybridization of bladder wall samples were negative. The patient was free from clinical signs and had an ultrasonographically normal urinary bladder 59 weeks after antimicrobial treatment was discontinued.
CLINICAL RELEVANCE
Malakoplakia, a granulomatous disease characterized by impaired histiocytes that are unable to completely digest phagocytized bacteria, is a very rare disease in dogs, but early suspicion of the condition is essential to allow timely diagnosis and avoid disease progression and the need for prolonged treatment. Malakoplakia should be considered in young dogs with chronic urinary tract infections; the diagnosis can be made through a combination of histologic examination and fluorescence in situ hybridization of bladder wall biopsy samples.
Topics: Animals; Dog Diseases; Dogs; Female; In Situ Hybridization, Fluorescence; Malacoplakia; Urinary Bladder; Urinary Bladder Diseases; Urinary Tract Infections
PubMed: 34968189
DOI: 10.2460/javma.20.12.0676 -
Journal of Clinical Ultrasound : JCU Feb 2022This case illustrates the untypical presentation of primary bladder malacoplakia. The patient was in her mid-50s have impaired immunity by the long-term hyperglycemic...
This case illustrates the untypical presentation of primary bladder malacoplakia. The patient was in her mid-50s have impaired immunity by the long-term hyperglycemic condition. She presented with symptoms of urinary tract infection and dysuria, and had multiple nodulars in bladder and significantly mass in urethra. Although the diagnosis of bladder malacoplakia was established on bladder biopsy, transperineal ultrasound examination can find its distinct clinical presentation.
Topics: Female; Humans; Malacoplakia; Male; Ultrasonography; Urethra; Urinary Bladder; Urinary Tract Infections
PubMed: 34889462
DOI: 10.1002/jcu.23106