Malakoplakia of the colon

Urinary tract malakoplakia with extension into the retroperitoneum with secondary gastrointestinal involvement

A rare case of malakoplakia of the urinary tract with diffuse retroperitoneal extension is presented. Sonographically guided cytologic puncture revealed the pathologic diagnosis. The splenic flexure of the colon and the stomach appeared to be secondarily involved in the inflammatory retroperitoneal tumor. The relative role of the various imaging modalities in defining retroperitoneal extension of the disease is illustrated, with a special reference to computed tomography and endosonography. After antimicrobial treatment and left nephrectomy, partial regression of the retroperitoneal mass was documented.

Colonic malacoplakia and abdominal tuberculosis in a child. Report of a case with review of the literature

A 4 1/2-year-old girl had colonic malacoplakia of two years' duration, the presenting symptom being rectal bleeding. Abdominal tuberculosis and Escherichia coli lumbar abscess were diagnosed at the age of 3 1/2 years. Despite antituberculous treatment, there was no improvement and she died from protein-losing enteropathy. The patient is discussed and the literature reviewed, with special emphasis on the incidence of malacoplakia in children, the aggressive nature of colonic malacoplakia, and the lack of response to treatment. A brief review of the pathogenesis of malacoplakia is considered.

Malakoplakia of testis

Two cases of malakoplakia of the testis are reported. Ultrastructural studies were performed in both cases and confirmed the histiocytic nature of the large cells seen in this granulomatous process. Characteristic Michaelis-Gutmann bodies are identified in those macrophages and seem to originate from altered lysosomes. From these observations and a review of the literature, the possible physiopathogenesis of the disease is summarized, and comments are made on the treatment of malakoplakia.

Malakoplakia of the colon and recurrent colonic strictures in a patient with primary hypogammaglobulinemia: an association not previously described

A nine-year old boy with primary hypogammaglobulinemia and recurrent colonic strictures who developed malakoplakia of the colon is reported on. Such an association has not been reported previously. The development of colonic strictures is not considered a gastrointestinal manifestation of hypogammaglobulinemia. Malakoplakia of the colon is a rare disease, with 26 cases being reported to date. Only five children under age 13 have been reported with colonic malakoplakia and none with hypogammaglobulinemia. Hypogammaglobulinemia should be added to the growing list of conditions predisposing to the development of malakoplakia.

Malakoplakia of the gastrointestinal tract

The clinical and pathological features of 3 cases of colonic malakoplakia are documented thereby bringing to 34 the total of recorded cases of malakoplakia involving the gastrointestinal tract. This is therefore the most common site of involvement outside the urogenital tract. A comprehensive review of the world literature on gastrointestinal malakoplakia has been made and the characteristic features of the condition have been delineated. There was a bimodal age incidence with a small cluster of cases occurring in childhood and associated with significant additional systemic disease. In the adult cases the average age was 57 years with a slight excess of males. The most commonly involved part of the gastrointestinal tract was the colon and colonic carcinoma was the most common associated disease.

An unusual case of supraclavicular and colonic malakoplakia--a light and ultrastructural study

A case of malakoplakia of the supraclavicular region and colon in a 41-year-old patient is presented. Clinical, histopathological, histochemical and ultrastructural features are described. The etiology and pathogenesis are discussed. Malakoplakia is a chronic inflammatory disorder probably due to an abnormal response to infection with Gram negative bacteria, most likely Escherichia coli or Klebsiella. The disease is characterised by the accumulation of macrophages intermixed with plasma cells and lymphocytes. The malakoplakic cells are laden with phagolysosomes which may provide a suitable biochemical environment for the deposition of calcium to form the pathognomonic Michaelis-Gutmann bodies. Ultrastructural examination enhances the accuracy of diagnosis since it highlights the presence of lysosomes, phagolysosomes, Michaelis-Gutmann bodies, and intact E. coli or their remnants.