Malakoplakia in a healthy young female patient

Abstract

Malakoplakia is a rare granulomatous disease that occurs commonly in the urinary tract and secondarily in the gastrointestinal tract. Most reported cases of malakoplakia are associated with immunosuppressive diseases or chronic prolonged illness. Here, we report a rare case of malakoplakia in a young healthy adolescent without any underlying disease. A 19-year-old female was referred to our hospital following the discovery of multiple rectal polyps with sigmoidoscopy. She had no specific past medical history but complained of recurrent abdominal pain and diarrhea for 3 months. A colonoscopy revealed diverse mucosal lesions including plaques, polyps, nodules, and mass-like lesions. Histological examination revealed a sheet of histiocytes with pathognomonic Michaelis-Gutmann bodies. We treated the patient with ciprofloxacin, the cholinergic agonist bethanechol, and a multivitamin for 6 months. A follow-up colonoscopy revealed that her condition was resolved with this course of treatment.

Reporte de un caso de Malacoplaquia renal: una enfermedad inusual de difícil diagnóstico

“…Se ha informado mayor incidencia en hombres, pero cuando afecta el tracto urinario las mujeres son afectadas más frecuentemente. No tiene predilección por raza y pueden afectar a personas de cualquier edad, aunque es más frecuente en personas mayores de 50 años (12,14).…”

Testicular malakoplakia: A rare sonographic mimic of malignancy

“…Malakoplakia is associated with compromised immune function, often in the setting of organ transplantation and immunosuppressive therapy. Other associations have included diabetes mellitus, human immunodeficiency virus, hepatic cirrhosis, tuberculosis, bacterial infection (eg, with Escherichia coli , Proteus spp., Staphylococcus aureus ), or malignancy (colon, prostate); its occurrence is extremely rare in normal individuals . Gram‐negative bacteria, most commonly E coli , are the organisms isolated.…”

“…Other associations have included diabetes mellitus, human immunodeficiency virus, hepatic cirrhosis, tuberculosis, bacterial infection (eg, with Escherichia coli, Proteus spp., Staphylococcus aureus), or malignancy (colon, prostate); its occurrence is extremely rare in normal individuals. 3,4 Gram-negative bacteria, most commonly E coli, are the organisms isolated. Pathologically, the diagnosis is made by finding the presence of Michaelis-Gutmann bodies and positive staining with PAS and for calcium.…”

Malakoplakia of the Appendiceal Orifice Mimicking Adenomatous Epithelium

“…2 As in the present case, endoscopic appearances of malakoplakia may mimic neoplastic changes. 3 This resemblance, especially in patients at high-risk for colorectal cancer such as our patient, potentially lead to a misdiagnosis and unnecessary invasive treatment. The coliform bacteria, particularly Escherichia coli, are the most common pathogens involved, therefore empiric therapy with appropriate antimicrobial agents targeting these microorganisms shows promise.…”

“…2 Remains of the incompletely destructed pathogens eventually will mineralize by calcium and iron depositions to form Michaelis-Gutmann bodies highlighted with Von Kossa stain for calcium; these concretions are pathognomonic of malakoplakia. 3 This rare entity may involve various organs, predominantly the urinary tract. 2 Although the gastrointestinal tract is the second most common site of malakoplakia, appendiceal involvement is extremely rare.…”