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Archives of Pathology & Laboratory... Feb 2007Malakoplakia is a rare granulomatous disease that occurs commonly in the urinary tract. Histologically, it is defined by sheets of histiocytes (Hansemann cells) with... (Review)
Review
CONTEXT
Malakoplakia is a rare granulomatous disease that occurs commonly in the urinary tract. Histologically, it is defined by sheets of histiocytes (Hansemann cells) with accumulation of granular basophilic periodic acid-Schiff-positive, diastase-resistant inclusions and calcified Michaelis-Gutmann bodies, which are pathognomonic but not necessary for diagnosis. In addition to the urinary tract, malakoplakia has been reported in other organs, including the gastrointestinal tract, central nervous system, female genital tract, and the tongue.
OBJECTIVES
To review the literature of reported sites of malakoplakia outside the urinary tract and their variable clinical presentations, and to discuss the main diagnostic features and differential diagnoses of malakoplakia. The pathogenesis and possible etiologic factors are also presented.
DATA SOURCES
Data for this work were collected from the published literature, textbooks, and the Internet.
CONCLUSIONS
It is important to be aware of the existence of this entity in abnormal locations. In many situations, malignancy can be mimicked, especially when the lesion is ulcerated and is accompanied by lymph node involvement. Misinterpreting large, rapidly growing nodules of malakoplakia as tumor might lead to overstaging. Pathologists should be also aware of the possibility of malakoplakia coexisting with other lesions, such as tuberculosis and carcinoma, in the same specimen.
Topics: Colonic Neoplasms; Diagnosis, Differential; Female; Gastrointestinal Tract; Humans; Malacoplakia; Male; Urogenital System
PubMed: 17284117
DOI: 10.5858/2007-131-297-MOTUT -
Journal of Clinical Pathology Aug 1990
Topics: Aged; Epithelium; Female; Humans; Malacoplakia; Urinary Bladder
PubMed: 2401741
DOI: 10.1136/jcp.43.8.696-b -
Urology Case Reports Jan 2022Granulomatous prostatitis is a rare condition that is diagnosed only by histopathological examination. Though rare, the condition was reported to have different...
Granulomatous prostatitis is a rare condition that is diagnosed only by histopathological examination. Though rare, the condition was reported to have different presentations (mimicking prostate cancer or prostatitis and prostatic abscess) and to have different etiologies which classified it into three main entities; nonspecific (idiopathic), post-surgery, and specific. Specific granulomatous prostatitis is further sub-classified to infective, xanthogranulomatous, Malacoplakia and associated with systemic granulomatous disease and allergy. We hereby report a rare case of xanthogranulomatous prostatitis that presented with persistent urinary tract infection.
PubMed: 34712584
DOI: 10.1016/j.eucr.2021.101887 -
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 -
Veterinary Pathology Jul 2021Malakoplakia in humans most often affects the urinary bladder and is characterized by inflammation with von Hansemann-type macrophages, with or without Michaelis-Gutmann...
Malakoplakia in humans most often affects the urinary bladder and is characterized by inflammation with von Hansemann-type macrophages, with or without Michaelis-Gutmann bodies, and is frequently associated with infection. We describe the microscopic features of malakoplakia in the urinary bladder of 4 puppies. In all cases, the lamina propria of the urinary bladder was markedly expanded by sheets of large, round to polygonal macrophages with intracytoplasmic, periodic acid-Schiff-positive granules and granular inclusions, and rare Prussian blue-positive inclusions. Macrophages were positive for CD18 and Iba1. In 2 cases, Michaelis-Gutmann bodies were detected with hematoxylin and eosin stain and were best demonstrated with von Kossa stain. infection was confirmed in 2 cases with bacterial culture or polymerase chain reaction (PCR) and sequencing of the bacterial 16S ribosomal RNA gene. Transmission electron microscopy of one case demonstrated macrophages with abundant lysosomes, phagolysosomes, and rod-shaped bacteria. Microscopic features were similar to human cases of malakoplakia. In dogs, the light microscopic characteristics of malakoplakia closely resemble granular cell tumors and histiocytic ulcerative colitis.
Topics: Animals; Dog Diseases; Dogs; Escherichia coli; Inclusion Bodies; Macrophages; Malacoplakia; Urinary Bladder
PubMed: 33888013
DOI: 10.1177/03009858211009779 -
Cureus Jan 2024Malacoplakia is an uncommon disease characterized by chronic and granulomatous inflammation, which rarely involves the female genital tract. We describe the ecographic...
Malacoplakia is an uncommon disease characterized by chronic and granulomatous inflammation, which rarely involves the female genital tract. We describe the ecographic and histological evolution of the first case of a patient developing endometrial malacoplakia as a complication after a cesarean section. The patient, a 43-year-old woman, presented with pelvic pain one month after delivering by cesarean section and the initial suspicion was of retention of placental rests. We discuss the diagnostic challenges for this rare disease, highlighting the importance of considering endometrial malacoplakia as a possible diagnosis in patients with similar clinical presentations and the important role of 2D and 3D ultrasound in the diagnostic pathway. In literature, ultrasound findings in cases of endometrial malacoplakia are represented by hypoechoic thickening of the endometrial lining; hyperechoic thickening of the myometrium, and the presence of masses, nodules, cystic areas, or anechoic fluid within the endometrium. For the first time, we describe the evolution of endometrial malacoplakia through both ultrasound, 2D and 3D, and histopathological findings, from the acute to chronic stage of the disease.
PubMed: 38352078
DOI: 10.7759/cureus.52268 -
The American Journal of Pathology Jun 1975Malakoplakia was induced experimentally by introducing large amounts of crude endotoxin-antigen comples of 075 Escherichia coli (E. coli 12797 CDC 0 group 75) into the...
Malakoplakia was induced experimentally by introducing large amounts of crude endotoxin-antigen comples of 075 Escherichia coli (E. coli 12797 CDC 0 group 75) into the kidneys and testes of rats. First leukocytes, then granulation tissue composed mainly of characteristic macrophages, the so-called Hansemann cells, appeared around the endotoxin-antigen mass. On the eighth day following the injection, deposition of calcium phosphate into the cytosegresomes of macrophages began and acused the formation of the Michaelis-Gutmann bodies necessary for the diagnosis of malakoplakia. The induction of the same process in humans by E coli endotoxin seems to be possible.
Topics: Animals; Antigens, Bacterial; Bacillus megaterium; Calcium Phosphates; Endotoxins; Escherichia coli; Granulation Tissue; Inclusion Bodies; Kidney Diseases; Leukocytes; Macrophages; Malacoplakia; Male; Microscopy, Electron; Rats; Rats, Inbred Strains; Testicular Diseases
PubMed: 166563
DOI: No ID Found -
Revista Da Associacao Medica Brasileira... 2011
Topics: Diagnosis, Differential; Humans; Malacoplakia; Male; Retroperitoneal Neoplasms; Sarcoma; Young Adult
PubMed: 22249538
DOI: 10.1590/s0104-42302011000600005 -
BMJ Case Reports Aug 2021A 45-year-old woman presented to us in March 2019 with complaints of fever and right lower quadrant abdominal pain for 1 month. She had undergone renal transplantation...
A 45-year-old woman presented to us in March 2019 with complaints of fever and right lower quadrant abdominal pain for 1 month. She had undergone renal transplantation in 2017 for end-stage renal disease and developed four episodes of urinary tract infection in the next 16 months post transplantation, which were treated based on culture reports. She was subsequently kept on long-term prophylaxis with trimethoprim and sulfamethoxazole. Her present laboratory parameters showed a normal blood picture and elevated creatinine. Urine culture grew Non-contrast CT of the abdomen-pelvis revealed an endo-exophytic hyperdense mass in the graft kidney showing local infiltration and associated few regional lymph nodes. PET-CT revealed the soft-tissue mass and regional lymph nodes to be hypermetabolic, raising the possibility of lymphoma. However, biopsy showed features of malakoplakia. She was subsequently initiated on long-term antibiotic therapy and her immunosuppression decreased.
Topics: Female; Humans; Kidney Transplantation; Lymphoproliferative Disorders; Malacoplakia; Middle Aged; Positron Emission Tomography Computed Tomography; Urinary Tract Infections
PubMed: 34400429
DOI: 10.1136/bcr-2021-244228 -
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