| Primary malacoplakia of the prostate is a rare benign disease, which is frequently mistaken for carcinoma and granulomatous prostatis. The surgical and clinical course of a patient with obstructive hypertrophy of the prostate is reviewed after an initial incorrect diagnosis of clear cell carcinoma. Experience in defining the lesion during the transurethral resection is presented. The pathogenesis, morphological structure and unique microscopic appearance of malacoplakia, characterized by large mononuclear cells associated with small laminated concretions, are described and illustrated. ( info) |
| AIMS: Three cases of chronic periapical periodontitis including focal areas with malakoplakia changes are reported. methods AND RESULTS: These areas included both von Hansemann-type macrophages and periodic acid-Schiff-positive, iron- and calcium-containing concretions. Some concretions corresponded to spherules with a targetoid configuration, thus fitting the morphological criteria for classical Michaelis-Gutmann bodies. CONCLUSION: The vast majority of the cases of malakoplakia that have been reported in the literature corresponded to a characteristic, fairly homogeneous lesion, but a few instances of focal malakoplakia have been described in various chronic conditions. These considerations support the opinion that the local conditions for the production of Michaelis-Gutmann bodies may occur focally in diseases characterized by macrophage accumulation. ( info) |
3/283. Pulmonary malacoplakia associated with rhodococcus equi infection in a patient with AIDS. An AIDS patient with a cavitary lung lesion was found to have pulmonary malacoplakia associated with rhodococcus equi infection. The diagnosis was based on the typical histologic features of transbronchial biopsy and a positive bacterial culture. All 13 reported cases of AIDS patients with pulmonary malacoplakia were associated with R equi. The recognition of this unique entity is important because of its responsiveness to therapy. ( info) |
4/283. Renal malacoplakia: an important consideration in the differential diagnosis of renal masses in the presence of escherichia coli infection. Renal malacoplakia is an uncommon condition with a variety of radiological characteristics which may initially suggest an alternative diagnosis. Three cases of renal malacoplakia were diagnosed in our hospital during a 2 year period. This apparent cluster of cases probably reflects the increased use of imaging and biopsy in the investigation of elderly hospitalized patients. It is important to make a definitive diagnosis as correct management may result in cure. ( info) |
| We present a well-documented case of biopsy-proven renal malacoplakia with an excellent response to oral fluoroquinolone therapy. ( info) |
6/283. Primary non-Hodgkin's lymphoma and malakoplakia of the vagina: a case report. The vagina is a rare site for both primary non-Hodgkin's lymphoma and malakoplakia. We report a case of concurrent diffuse large B-cell lymphoma and malakoplakia of the vagina in a 67-year-old woman presenting with a vaginal discharge and a vaginal mass. The patient had two biopsy specimens reported as showing malakoplakia only, followed by a third biopsy specimen 10 months later which was diagnosed as diffuse large B-cell lymphoma. review of the first two biopsy specimens showed areas of histiocytes with Michaelis-Gutman bodies merging with areas of cells with slightly larger nuclei and more amphophilic cytoplasm. immunohistochemistry for the B-cell marker L-26 (CD20) and polymerase chain reaction analysis of the immunoglobulin heavy chain gene were helpful in retrospectively distinguishing the population of diffuse large B-cell lymphoma from the areas of malakoplakia. The third biopsy specimen showed sheets of large atypical lymphoid cells characteristic of a large cell lymphoma. Malakoplakia has been described in association with a variety of cancers, and this is only the second report of malakoplakia associated with non-Hodgkin's lymphoma. Considering the rarity of these two entities in the vagina, it is unlikely that the association in this case is coincidental, raising the possibilities of an unusual reaction to the presence of lymphoma or a common pathogenesis such as underlying chronic inflammation. Epstein-Barr virus dna was detected in the second biopsy specimen, suggesting a possible role in the pathogenesis of this lymphoma. ( info) |
7/283. Malakoplakia of the caecum in a kidney-transplant recipient: presentation as acute tumoral perforation and fatal outcome. Malakoplakia is a rare pseudotumoral inflammatory disease known to affect immunocompromised subjects, mainly with a history of recurrent escherichia coli infection. The urinary tract is the most frequent site of the disease, although all organs can be involved. In the present article, we report a case of malakoplakia of the caecum, that developed in a 52-year-old man, who had received a kidney transplant 9 years before and had a history of recurrent E. coli urinary tract infections. Malakoplakia presented as acute intestinal perforation, and, despite aggressive surgical and medical management, disease progressed toward a fatal outcome due to sepsis and multiple organ failure 9 months later. A defect in the macrophagic activity was demonstrated. ( info) |
8/283. Malakoplakia and tuberculosis. A 33 year old woman developed a soft mass in the left anterior neck following treatment for pulmonary tuberculosis. An incisional biopsy was performed and a cold abscess drained. histology confirmed a diagnosis of tuberculosis. In addition, there were numerous intracellular bodies which resembled the Michaelis-Gutmann bodies of malakoplakia. This case however displayed some atypical histological, histochemical and ultrastructural features, which are highlighted in this report. The mass responded to combination antituberculous treatment. ( info) |
9/283. Malakoplakia of the testis. Two cases of malakoplakia of the testis are presented. Malakoplakia (soft plaque) is an uncommon chronic inflammatory condition of granulomatous type, the common denominator of which would appear to be an altered reactivity of macrophages. Its hallmark is the presence of Michaelis-Guttman bodies. Until the late 1950s, when a case involving the testis was described, the condition was thought to involve only the mucosae of the bladder, ureters, and renal pelvis. The most recent review of malakoplakia of the testis included only 10 known cases. ( info) |
10/283. Cerebral malakoplakia associated with escherichia coli infection. Malakoplakia is an unusual chronic inflammatory disease occurring predominantly in the bladder and only rarely affecting other organs. For the urinary tract, its aetiology has been ascribed to the presence of escherichia coli, while the very few cases of cerebral malakoplakia which have been reported so far, have mostly occurred in infants in the clinical setting of neonatal herpes virus infection or otherwise in adults in areas of cerebral infarction. We here report a case of E. coli-associated malakoplakia of the brain. It occurred in a 53-year-old man who had undergone long-term corticosteroid therapy and had previously been operated on a cerebral E. coli-associated abscess. This case indicates that malakoplakia of the brain might also be a histiocytic reaction against bacterial antigens of the E. coli family. ( info) |