Abstract:loops of small bowel. No discrete lymph nodes were identified and no free air or free fluid was seen within the abdominal cavity. A colonoscopy study was scheduled in view of the CT findings, which showed a friable, stenotic tumour, 68 cm from the anal verge, which extended 10 cm proximally obstructing approximately 80% of the bowel lumen. Histological examination of a biopsy of the lesion showed adenocarcinoma. Other significant laboratory findings included decreased haemoglobin (10.6 mg/dL), elevated carcino… Show more
“…They are readily identified on hematoxylin and eosin, von-Kossa, periodic acid Schiff or iron stains (Fig. 2 a, b) [ 1 , 6 , 7 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…1 a, b), flat lesions, ulceration, mucosal erosions or plaques. Mass forming tumors mimicking malignancy have also been described [6][7][8]. Malakoplakia was initially described and most commonly found in the genitourinary tract but since its initial discovery in the early twentieth century, it has been reported in nearly every organ system, including the gastrointestinal [9][10][11][12][13][14][15], liver [16], central nervous system [17], renal [18], and pulmonary tract [19].…”
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 comorbidities (i.e. diabetes and organ transplant). Twenty-one patients with malakoplakia were in an immunosuppressive state (21/23, 91%).
“…They are readily identified on hematoxylin and eosin, von-Kossa, periodic acid Schiff or iron stains (Fig. 2 a, b) [ 1 , 6 , 7 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…1 a, b), flat lesions, ulceration, mucosal erosions or plaques. Mass forming tumors mimicking malignancy have also been described [6][7][8]. Malakoplakia was initially described and most commonly found in the genitourinary tract but since its initial discovery in the early twentieth century, it has been reported in nearly every organ system, including the gastrointestinal [9][10][11][12][13][14][15], liver [16], central nervous system [17], renal [18], and pulmonary tract [19].…”
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 comorbidities (i.e. diabetes and organ transplant). Twenty-one patients with malakoplakia were in an immunosuppressive state (21/23, 91%).
“…Although malakoplakia usually mimics malignancy, less than 30 cases of malakoplakia in association with adenocarcinoma of colon and rectum have been reported in English literature so far (9-12). Previous reports noted the possibility of over-estimating the pre-operative clinical stage of the disease, which can result in unsuitable treatment of the patients (9). Our patient was a 59 year-old man with pre-operative diagnosis of sigmoid adenocarcinoma and clinical stage of T4aN2 who underwent surgery.…”
Malakoplakia is a rare granulomatous disease of the genitourinary system. Gastrointestinal tract is the second most common site of involvement. It usually mimics a malignancy but its association with adenocarcinoma has been rarely reported. A 59-year-old male patient with the history of weight loss and rectal bleeding for two months prior to administration was referred to our hospital. Pre-operative CT scan revealed a large sigmoid colon mass with the extension and invasion to the serosal surface as well as multiple regional metastatic lymph nodes. The patient underwent sigmoidectomy with the primary pathologic diagnosis of adenocarcinoma. Pathologic examination revealed a moderately differentiated adenocarcinoma invading peri-colic adipose tissue and inflammatory reaction compatible with malakoplakia at the invasive borders of the tumor with the extension to the serosal surface.In the patients with gastrointestinal malakoplakia, the presence of possible adjacent malignancy should be screened. The possibility of over-staging should also be considered for adenocarcinoma cases in association with malakoplakia.
“…La malacoplaquia bilateral ha sido relacionada con alta mortalidad (15,16). Se han descrito casos asociados con neoplasias del tracto urinario y de otros órganos (17)(18)(19).…”
La malacoplaquia es una enfermedad granulomatosa crónica inicialmente descrita en las vías urinarias, pero posteriormente encontrada en múltiples órganos. La presentación clínica depende del sitio comprometido; en el tracto urinario produce disuria, dolor pélvico o abdominal, fiebre, malestar general y, a veces, sensación de masa. Su etiopatogenia aún no ha sido completamente entendida, pero se cree que es debida a un trastorno en la función lisosomal de los macrófagos que afecta la destrucción de las bacterias. Histológicamente se caracteriza por presentar macrófagos llamados "células de von Hansemann" e inclusiones de Michaelis-Gutmann. Describimos el caso de una paciente con diabetes mellitus de larga evolución y malacoplaquia renal que le produjo síntomas debilitantes crónicos.
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