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Lim SY, Yim HS, Ahn EJ, Chang E, Yoon J, Suh JH, Um J, Kim HS, Kim MK, Kim Y, Kim G, Jeon J, Park JS, Chin B. Severe mpox requiring colostomy in a patient with advanced HIV disease: A case report and literature review. J Infect Chemother 2024:S1341-321X(24)00172-7. [PMID: 38936771 DOI: 10.1016/j.jiac.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/26/2024] [Accepted: 06/21/2024] [Indexed: 06/29/2024]
Abstract
This severe monkeypox case described a 23-year-old male with advanced HIV-1 disease presenting perirectal abscess, extensive anal ulcerative lesions requiring colostomy, and tecovirimat resistance. Radiologically non-liquefied perirectal abscess presented diagnostic challenges highlighting the complexity of aggressive monkeypox manifestations in immunocompromised individuals.
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Affiliation(s)
- So Yun Lim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Republic of Korea
| | - Hong Soon Yim
- Public Health Research Institute, National Medical Center, Republic of Korea
| | - Eun Jung Ahn
- Department of Surgery, National Medical Center, Republic of Korea
| | - Euijin Chang
- Department of Infectious Diseases, Asan Medical Center, Republic of Korea
| | - Jonghee Yoon
- Department of Surgery, Asan Medical Center, Republic of Korea
| | - Ja-Hee Suh
- Department of Pathology, National Medical Center, Republic of Korea
| | - Jihye Um
- Public Health Research Institute, National Medical Center, Republic of Korea
| | - Hyang Su Kim
- Public Health Research Institute, National Medical Center, Republic of Korea
| | - Min-Kyung Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Republic of Korea
| | - Yeonjae Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Republic of Korea
| | - Gayeon Kim
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Republic of Korea
| | - Jaehyun Jeon
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Republic of Korea
| | - Jun-Sun Park
- Public Health Research Institute, National Medical Center, Republic of Korea
| | - BumSik Chin
- Division of Infectious Diseases, Department of Internal Medicine, National Medical Center, Republic of Korea.
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2
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Rodríguez González OE, Osorio JE, Bravo Castro EI. Adrenal malakoplakia a rare lesion that mimics a neoplasm. Urol Case Rep 2023; 51:102568. [PMID: 37781485 PMCID: PMC10539889 DOI: 10.1016/j.eucr.2023.102568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Background Malakoplakia is a rare disorder 75% of the reported cases affect mainly the genitourinary tract, its occurrence in the adrenal gland is extremely rare. Case presentation A 65-year-old female patient presented to the emergency department for chronic abdominal pain. Radiographic and biochemical studies revealed a left adrenal incidentaloma and left adrenalectomy was performed. Histological examination showed the presence of Michaelis-Gutmann bodies, compatible with a malakoplakia of the adrenal gland. Conclusions Malakoplakia is a rare disorder, with non-standardized treatment, medical and surgical therapies appear to be effective in treating the condition.
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Affiliation(s)
- Orión Erenhú Rodríguez González
- Escuela Militar de Graduados de Sanidad, Batalla de Celaya 202, Lomas de Sotelo, Militar, Miguel Hidalgo, 11200, Ciudad de México, Mexico
- Hospital Militar Regional de Especialidades Guadalajara, Reforma, Colonia Centro, C.P. 44890, Guadalajara, Jalisco, Mexico
| | - Jesus Eduardo Osorio
- Escuela Militar de Graduados de Sanidad, Batalla de Celaya 202, Lomas de Sotelo, Militar, Miguel Hidalgo, 11200, Ciudad de México, Mexico
- Hospital Central Militar, Periférico Blvrd Manuel Ávila Camacho S/n, Militar, C.P. 11200, Miguel Hidalgo, Ciudad de México, Mexico
| | - Edgar Iván Bravo Castro
- Hospital Central Militar, Periférico Blvrd Manuel Ávila Camacho S/n, Militar, C.P. 11200, Miguel Hidalgo, Ciudad de México, Mexico
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3
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A Surgical Challenge Generated by Colonic Malakoplakia in Disguise as a Locally Advanced Colonic Malignancy-A Case Report. Medicina (B Aires) 2023; 59:medicina59010156. [PMID: 36676780 PMCID: PMC9860922 DOI: 10.3390/medicina59010156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Colonic malakoplakia is an uncommon granulomatous development of cells resulting from the impaired capacity of the mononuclear cells to eliminate the phagocytosed bacteria, and in rare cases it can also affect the gastrointestinal tract. We report the case of a 78-year-old female patient that was admitted to hospital by The Emergency Department with the diagnosis of bowel obstruction, confirmed by the clinical and paraclinical investigations. We decided to surgically manage the case for suspicious symptomatic colonic neoplasm. The histological examination of the surgical specimens revealed colonic malakoplakia, characterized by the presence of the aggregated granular histiocytes and Michaelis-Gutmann bodies. Through this paper, we want to raise awareness for Malakoplakia, which remains an extremely rare disease that may affect multiple organs, and because it does not present specific symptoms or clinical manifestations, the final diagnosis remains the histopathological study. The clinical conduct should be decided after taking into consideration all the aspects of this pathology along with the benefits and risks for the patient.
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4
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Zeng S, Li S, Yang Q, Tang Q, Tang X, Li M, Huang P. Malakoplakia of Larynx: A Case Report and Literature Review of Localized Malakoplakia of Larynx. J Voice 2022:S0892-1997(22)00243-0. [PMID: 36089557 DOI: 10.1016/j.jvoice.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Malakoplakia is a very rare benign granulomatous disease, which can invade multiple organ systems, and is often related to bacterial infection and weak immunity. It is rarely occurred in the larynx, once this happens, the patient would complain of cough, hoarseness, dysphagia, and even dyspnea. METHODS We reported a case of malakoplakia of larynx. The patient complained of hoarseness and cough. Her lesion was located in the right false vocal cord. six case reports of malacoplakia in larynx were compiled from the literature and integrated with this case report. RESULTS After excising the tumor, the symptoms of the patient with cough, hoarseness and dysphagia were improved, and there was no recurrence during 1-year follow-up. The postoperative pathological diagnosis is malakoplakia. We found that malacoplakia is more commonly located in the supraglottic region, and we speculate that there may be a relationship between larynx-associated lymphoid tissue (LALT) and laryngeal malakoplakia. The effect of surgical treatment for laryngeal malacoplakia is satisfactory. CONCLUSION Malakoplakia of the larynx is rare. Bacterial infection, immune deficiency, and the distribution of LALT may be related to the pathogenesis and supraglottic localization of malakoplakia. The symptoms are related to the location and size of the mass and may be serious and fatal. Surgery is an important treatment for preserving laryngeal function and low recurrence rate.
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Affiliation(s)
- Shiying Zeng
- Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 168 Shaoshan North Road, Furong district, Changsha, Hunan, China
| | - Shisheng Li
- Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 168 Shaoshan North Road, Furong district, Changsha, Hunan, China.
| | - Qian Yang
- Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 168 Shaoshan North Road, Furong district, Changsha, Hunan, China
| | - Qinglai Tang
- Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 168 Shaoshan North Road, Furong district, Changsha, Hunan, China
| | - Xiaojun Tang
- Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 168 Shaoshan North Road, Furong district, Changsha, Hunan, China
| | - Mengmeng Li
- Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 168 Shaoshan North Road, Furong district, Changsha, Hunan, China
| | - Peiying Huang
- Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 168 Shaoshan North Road, Furong district, Changsha, Hunan, China
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5
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Acosta AM, Sangoi AR, Maclean F, Trpkov K, Osunkoya AO, Collins K, Miyamoto H, Hirsch MS, Chan E, Tretiakova M, Mohanty SK, Kaushal S, Cornejo KM, Aron M, Quiroga-Garza G, Arora K, Nguyen JK, Williamson SR, Epstein JI, Matoso A. Prostatic Malakoplakia: Clinicopathologic Assessment of a Multi-institutional Series of 49 Patients. Histopathology 2022; 81:520-528. [PMID: 35876721 DOI: 10.1111/his.14729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 11/27/2022]
Abstract
Prostatic MP is rare, with only case reports and small series (<5 patients) available in the literature. In this study we analyzed an international multi-institutional series of 49 patients with prostatic MP to better define its clinicopathologic features. The median age was 67 years, and the median serum PSA was 7.5 ng/mL. MP was clinically manifest in most cases (28/45 patients with data available, 62%). Of 43 patients with detailed clinical history available, 21 (49%) had concurrent or metachronous malignancies (including prostate cancer). Diabetes or insulin resistance was present in 11 patients (26%). Additionally, 3 patients had a history of solid organ transplantation and 1 had HIV. Of note, 6/34 patients (18%) without concurrent prostate cancer had an abnormal digital rectal examination or PIRADS ≥ 4 lesions on MRI. The initial diagnosis was made on core biopsies (25/49, 51%), transurethral resection specimens (12/49, 24%), radical prostatectomies (10/49, 20%), Holmium-laser enucleation (1/49, 2%) and cystoprostatectomy (1/49, 2%). Tissue involvement was more commonly diffuse or multifocal (40/49, 82%). Von Kossa and Periodic acid-Schiff stains were positive in 35/38 (92%) and 26/27 lesions (96%), respectively. Of note, 2 cases were received in consultation by the authors with a preliminary diagnosis of mesenchymal tumor/tumor of the specialized prostatic stroma. In conclusion, the present study, which is the largest to date, suggests that prostatic MP often manifests with signs and symptoms that may mimic those of prostate cancer in a subset of patients. Moreover, MP may be found incidentally in patients with concurrent prostate cancer.
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Affiliation(s)
- Andres M Acosta
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Fiona Maclean
- Douglass Hanly Moir Pathology and Macquarie University, Sydney, Australia
| | - Kiril Trpkov
- Rockyview General Hospital and University of Calgary, Calgary, AB, Canada
| | | | - Katrina Collins
- Indiana University Health and Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Michelle S Hirsch
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Emily Chan
- UCSF Medical Center, University of California San Francisco, San Francisco, CA, USA
| | | | - Sambit K Mohanty
- CORE Diagnostics, Gurgaon, India.,Advanced medical Research Institute, Bhubaneswar, India
| | - Seema Kaushal
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Manju Aron
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | | | | | - Jonathan I Epstein
- The Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA
| | - Andres Matoso
- The Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA
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6
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Enríquez-Pineda ÓM, Segura-Rivera JR, Ruiz-Morales JM, Mendoza-Valdés A, Dorantes-Heredia R. [An unusual association of malakoplakia and adenocarcinoma of the prostate]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55:46-51. [PMID: 34980441 DOI: 10.1016/j.patol.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/10/2019] [Accepted: 06/13/2019] [Indexed: 06/14/2023]
Abstract
Malakoplakia is a chronic inflammatory process caused by a lysosomal defect in bacterial digestion. Although rare, it occurs more frequently in the genitourinary tract and in patients with immune dysfunction. The bladder is the most commonly affected site, although cases have been reported in other organs, including the prostate gland. Clinically, this lesion can be confused with malignant tumours, both on physical examination and imagining techniques. This is particularly pronounced in the prostate, making the differential diagnosis challenging. Histologically, characteristic aggregates of histiocytes with basophilic intracytoplasmic inclusions composed of calcium and iron salts are found. We present a case diagnosed on transrectal biopsy as acinar adenocarcinoma with a Gleason 5 + 5 = 10 score. Prostatectomy revealed an unusual association of diffuse prostate malakoplakia and an area of acinar adenocarcinoma with a Gleason score of 3 + 4 = 7.
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Affiliation(s)
| | - Jesús Román Segura-Rivera
- Departamento de Anatomía Patológica, Hospital y Fundación Clínica Médica Sur, Ciudad de México, México
| | | | - Arturo Mendoza-Valdés
- Servicio de Urología Avanzada, Hospital y Fundación Clínica Médica Sur, Ciudad de México, México
| | - Rita Dorantes-Heredia
- Departamento de Anatomía Patológica, Hospital y Fundación Clínica Médica Sur, Ciudad de México, México.
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7
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George B, Clement CG. Xanthogranulomatous salpingo-oophoritis associated with diverticular perforation. HUMAN PATHOLOGY: CASE REPORTS 2021. [DOI: 10.1016/j.ehpc.2021.200539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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8
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Subbaraya S, Sawant A, Pawar P, Patil S. Malakoplakia prostate presenting as urinary retention: a report of two cases and review of the literature. BMJ Case Rep 2021; 14:14/7/e243927. [PMID: 34321270 PMCID: PMC8319990 DOI: 10.1136/bcr-2021-243927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Malakoplakia is a rare chronic inflammatory condition, which primarily occurs in genitourinary tract, with prostatic malakoplakia being extremely rare. We present two cases of acute urinary retention, with clinically firm nodular prostate and a raised serum prostate-specific antigen. Transrectal ultrasound-guided prostatic biopsy showed features of malakoplakia. There was a significant reduction of size of prostate on transrectal ultrasonography after 4 weeks of antibiotics. However, one patient had failed trial without catheter and was subjected to transurethral resection of prostate. The biopsy of the prostatic chips also showed features of malakoplakia. Other patient improved symptomatically after antibiotics and was managed conservatively. Both the patients are on regular follow-up and are asymptomatic. Prostatic malakoplakia presenting as urinary retention is very uncommon with around 12 cases in the literature. Recognition of prostatic malakoplakia is important because clinically it can masquerade prostatic malignancy. Treatment with antibiotics is necessary before subjecting the patients for surgery in patients with obstructive symptoms.
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Affiliation(s)
| | - Ajit Sawant
- Department of Urology, LTMMC & GH, Mumbai, Maharashtra, India
| | - Prakash Pawar
- Department of Urology, LTMMC & GH, Mumbai, Maharashtra, India
| | - Sunil Patil
- Department of Urology, LTMMC & GH, Mumbai, Maharashtra, India
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9
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Zahid M, Nepal P, Nagar A, Batchala PP, Kumar D, Ojili V. Imaging of ureter: a primer for the emergency radiologist. Emerg Radiol 2021; 28:815-837. [PMID: 33851303 DOI: 10.1007/s10140-021-01930-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Abstract
In this review article, we will discuss the gamut of abnormalities involving the ureters. In the emergency department, ureterolithiasis is the most common indication for imaging abdomen and pelvis. However, spectrum of ureteral abnormalities including congenital, infectious and inflammatory, primary and secondary ureteral malignancies, retroperitoneal fibrosis rare described in this article may be encountered. Thus, we will describe acute subacute as well as chronic conditions that may affect ureter. Knowledge of common, as well as rare entities and their imaging features, is of utmost importance to enable appropriate management.
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Affiliation(s)
- Mohd Zahid
- Department of Radiology, University of Alabama, Birmingham, AL, USA
| | - Pankaj Nepal
- Department of Radiology, St. Vincent's Medical Center, Bridgeport, CT, USA
| | - Arpit Nagar
- Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Prem P Batchala
- Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA
| | - Devendra Kumar
- Department of Clinical Imaging, Al Wakra Hospital, Hamad Medical Corporation, Al Wakra, Qatar
| | - Vijayanadh Ojili
- Department of Radiology, University of Texas Health, San Antonio, TX, USA.
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10
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Amsellem J, Corgibet F, Ponnelle T, Dauendorffer JN. [Penile malakoplakia associated with lichen sclerosus]. Ann Dermatol Venereol 2019; 146:812-816. [PMID: 31627929 DOI: 10.1016/j.annder.2019.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/25/2019] [Accepted: 07/26/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Malakoplakia is a granulomatosis of infectious origin in reaction to a chronic bacterial infection (most commonly urinary Escherichiacoli) related to an acquired phagocytosis impairment. PATIENTS AND METHODS We report a case of penile malakoplakia in a 69-year-old man with lichen sclerosis and stenosis of the urinary meatus leading to recurrent urinary tract infections. The clinical aspect was suggestive of squamous cell carcinoma of the glans developing on lichen sclerosus, but histological examination revealed penile malakoplakia. DISCUSSION Malakoplakia of the genital mucosa is rare, with only one case of involvement of the glans being reported in the literature. The association with lichen sclerosus is probably not fortuitous but could in fact be due to chronic urinary tract infection favored by stenosis of the urethral meatus and possible local immunodepression following prolonged application of clobetasol. CONCLUSION We report a case of penile malakoplakia associated with chronic E. coli urinary tract infection, due originally to associated genital lichen sclerosus.
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Affiliation(s)
- J Amsellem
- Service de dermatologie, CHI Robert Ballanger, boulevard Robert-Ballanger, 93600 Aulnay-sous-Bois, France.
| | - F Corgibet
- Cabinet de dermatologie, 5, avenue du Maréchal-Foch, 21000 Dijon, France
| | - T Ponnelle
- Centre de pathologie Cypath, 33, rue Nicolas-Bornier, 21000 Dijon, France
| | - J N Dauendorffer
- Service de dermatologie, centre des MST, hôpital Saint-Louis, 42, rue Bichat, 75010 Paris, France
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11
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Samian C, Ghaffar S, Nandapalan V, Santosh S. Malakoplakia of the parotid gland: a case report and review of localised malakoplakia of the head and neck. Ann R Coll Surg Engl 2019; 101:309-312. [PMID: 30855168 PMCID: PMC6513360 DOI: 10.1308/rcsann.2019.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Malakoplakia is a rare chronic inflammatory disorder, predominantly affecting the urinary tract. In the head and neck region, it is very rare and may confuse the clinicians during investigations, as features may mimic malignancy. MATERIALS AND METHODS We report a case of malakoplakia involving the parotid gland and review of the reported cases of malakoplakia in head and neck region. RESULTS Histologically, this is the first classic case report of malakoplakia involving the parotid gland in the world literature. A total of 49 cases have been reported in the head and neck region; 38.7% of these are cutaneous. In soft tissue, the tongue is the most common site. Salivary gland involvement is very rare. Previously, submandibular salivary gland involvement has been reported. CONCLUSION A possibility of malakoplakia should be considered as a differential diagnosis in patients with enlarged head and neck masses. Histology is essential to diagnose this benign inflammatory disorder and to differentiate from a malignant process.
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Affiliation(s)
- C Samian
- Department of Otorhinolaryngology and Head and Neck Surgery, St Helens and Knowsley NHS Teaching Hospitals, Whiston, Merseyside, UK
| | - S Ghaffar
- Department of Otorhinolaryngology and Head and Neck Surgery, St Helens and Knowsley NHS Teaching Hospitals, Whiston, Merseyside, UK
| | - V Nandapalan
- Department of Otorhinolaryngology and Head and Neck Surgery, St Helens and Knowsley NHS Teaching Hospitals, Whiston, Merseyside, UK
| | - S Santosh
- Department of Pathology, St Helens and Knowsley NHS Teaching Hospitals, Whiston, Merseyside, UK
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13
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Yared RA, Badran HA, Kamareddine MH, Ghosn Y, Bou Khalil R, El Ajamy K, Chouairy C, Farhat SG. Colonic Malakoplakia: A Rare Finding in a Healthy Male. Case Rep Gastroenterol 2018; 12:453-456. [PMID: 30186099 PMCID: PMC6120369 DOI: 10.1159/000492208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/17/2018] [Indexed: 02/05/2023] Open
Abstract
Malakoplakia is a rare chronic granulomatous disease that may affect many organs, including the lung, brain, adrenal glands, pancreas, bone, and the genitourinary tract. The gastrointestinal tract is the most common site of involvement outside of the urinary tract. Herein, we present a case of a 65-year-old male who presented with abdominal pain and unintentional weight loss. Physical examination findings were unremarkable, but colonoscopy revealed an isolated large, flat, soft, and pale lesion in the transverse colon. Histopathological examination of the lesion showed expansion of the lamina propria due to numerous lymphocytes, plasma cells, neutrophils, and polygonal cells. Von Kossa stain showed small intracytoplasmic basophilic granular inclusions, and these histiocyte cells showed numerous Michaelis-Gutmann bodies, findings considered as diagnostic features of colonic malakoplakia. This is a rare case of isolated malakoplakia of the transverse colon diagnosed on endoscopic specimens. The majority of reported cases have shown an association between systemic diseases and colorectal adenocarcinoma. In addition, most reported cases of colonic involvement have been in the rectum, sigmoid, and right colon.
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Affiliation(s)
- Rawad A. Yared
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Hussein A. Badran
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Mohammed Hussein Kamareddine
- Saint George Hospital University Medical Center, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Youssef Ghosn
- Saint George Hospital University Medical Center, Faculty of Medicine and Medical Sciences, University of Balamand, Beirut, Lebanon
| | - Roula Bou Khalil
- Department of Endocrinology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Khaled El Ajamy
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Camil Chouairy
- Department of Pathology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Said G. Farhat
- Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
- *Assist. Prof. Said G. Farhat, MD, Department of Gastroenterology, Saint George Hospital University Medical Center, University of Balamand, PO Box 166378, Achrafieh, Beirut (Lebanon), E-Mail
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14
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Ho M, Wu J, Skinnider B, Kavanagh A. Prostatic malakoplakia: a case report with review of the literature. J Surg Case Rep 2018. [DOI: 10.1093/jscr/rjy050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Matthew Ho
- Department of Urological Sciences, University of British Columbia, Vancouver, Canada V5Z 1M9
| | - Jeremy Wu
- University of Alberta Medical School, Edmonton, Canada T6G 2R3
| | - Brian Skinnider
- Department of Pathology, Vancouver General Hospital, Vancouver, Canada V5Z 1M9
| | - Alex Kavanagh
- Department of Urological Sciences, University of British Columbia, Vancouver, Canada V5Z 1M9
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Abstract
Malakoplakia is an unusual inflammatory disease with uncertain pathogenesis affecting any organ in the body, but predominantly genitourinary tract, with specific predilection to the bladder. We report a rare case of isolated malakoplakia of the urachus in a 29-year-old male patient who presented with lower urinary tract symptoms without any hematuria. Investigations revealed sterile pyuria with no bacterial growth in urine. Radiological investigations revealed a mass in the urachal region. The patient underwent cystoscopy with biopsy followed by pelvic lymph node dissection and partial cystectomy with excision of the urachal mass. Histopathological examination of the mass revealed malakoplakia. Postoperative course was uneventful. To the best of our knowledge, this is the first ever case report of isolated urachal malakoplakia without any concomitant malignancy or bladder involvement reported in our country and one of the very few reported worldwide.
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Affiliation(s)
- Saisriharsha Pakalapati
- Department of Urology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Sanjay Parachuri
- Department of Urology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Venkateshwara Rao Kakarla
- Department of Urology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Mahesh Babu Byrappa
- Department of Urology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
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Malakoplakia associated with prostatic adenocarcinoma. Ann Diagn Pathol 2016; 22:33-7. [DOI: 10.1016/j.anndiagpath.2016.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 03/11/2016] [Indexed: 11/21/2022]
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Moosavi B, Fasih N, Virmani V, Kielar A. Beyond ureterolithiasis: gamut of abnormalities affecting the ureter. Clin Imaging 2016; 40:678-90. [PMID: 27317212 DOI: 10.1016/j.clinimag.2016.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 12/08/2015] [Accepted: 01/06/2016] [Indexed: 12/31/2022]
Abstract
Nephrolithiasis is the most common condition involving the ureters. However, various other entities can affect the ureters, albeit less frequently. Imaging plays a crucial role in diagnosis, management, and follow-up of ureteral pathology. In the past decade, computed tomography urography has replaced traditional methods of ureteral imaging due to its high spatial resolution, multiplanar imaging, and rapid acquisition time. More recently, magnetic resonance urography has also been explored in evaluating ureteral abnormalities. In this review, we briefly discuss current imaging techniques used in assessment of the ureters and present a diverse group of diseases affecting the ureters. We begin with primary and secondary ureteral malignancies, followed by uncommon infectious/inflammatory diseases that can involve the ureters including tuberculosis, xanthogranulomatous pyelonephritis, and graft-versus-host disease. We then discuss the imaging characteristics of endometriosis and retroperitoneal fibrosis as two important examples of pelvic and retroperitoneal processes that occasionally obstruct the ureters and present with clinical symptoms similar to that of renal stones. We end with a brief discussion of miscellaneous conditions that affect the ureters, including ureteral hemorrhage, ureteral intussusception, ureteral pseudodiverticulosis, Malacoplakia, and ureteritis cystica. Knowledge of these entities and their characteristic imaging manifestations along with patient's clinical presentation allows accurate diagnosis and timely patient management.
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Affiliation(s)
- Bardia Moosavi
- The Ottawa hospital, Department of Radiology Civic Campus, 1053 Carling Avenue, Room C120, Ottawa, ON, K1T4E9.
| | - Najla Fasih
- The Ottawa hospital, Department of Radiology, 501 Smyth Road, Ottawa, ON, K1H 8L6.
| | - Vivek Virmani
- The Ottawa hospital, Department of Radiology, 501 Smyth Road, Ottawa, ON, K1H 8L6.
| | - Ania Kielar
- The Ottawa hospital, Department of Radiology, 501 Smyth Road, Ottawa, ON, K1H 8L6.
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Elktaibi A, Elochi MR, Sinaa M, Allaoui M, Alami Y, Amrani M. [Pseudotumoral malakoplakia of the breast]. Pan Afr Med J 2015; 21:87. [PMID: 26491530 PMCID: PMC4594986 DOI: 10.11604/pamj.2015.21.87.3966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 11/06/2014] [Indexed: 11/11/2022] Open
Abstract
La malakoplakie est une maladie inflammatoire granulomateuse chronique, qui affecte généralement le tractus génito-urinaire et exceptionnellement la glande mammaire. Il faut savoir évoquer ce diagnostic devant une mastite pseudotumorale. Sa définition est anatomopathologique. Nous rapportons un cas inhabituel de malakoplakie mammaire chez une patiente ayant des antécédents de tuberculose. L'imagerie était en faveur d'une mastite carcinomateuse. L'analyse histologique de la biopsie mammaire révélait une inflammation granulomateuse faite d'histiocytes renfermant des granulations pathognomoniques de Michaelis-Gutmann. La patiente était mise sous traitement médical à base de ciprofloxacine avec bonne évolution clinique et radiologique après un recul d'un mois.
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Affiliation(s)
- Abderrahim Elktaibi
- Service d'Anatomie et Cytologie Pathologiques, Institut National d'Oncologie, Rabat, Maroc
| | - Mohamed Reda Elochi
- Service d'Anatomie et Cytologie Pathologiques, Institut National d'Oncologie, Rabat, Maroc
| | - Mohamed Sinaa
- Service d'Anatomie et Cytologie Pathologiques, Institut National d'Oncologie, Rabat, Maroc
| | - Mohamed Allaoui
- Service d'Anatomie et Cytologie Pathologiques, Institut National d'Oncologie, Rabat, Maroc
| | - Yassir Alami
- Service de Chirurgie, Institut National d'Oncologie, Rabat, Maroc
| | - Mariam Amrani
- Service d'Anatomie et Cytologie Pathologiques, Institut National d'Oncologie, Rabat, Maroc
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Archer SR, Abramowsky CR, Kobrynski L, Simoneaux S, Vogler LB, Ricketts RR, Parker C, Elawahbdeh N, Shehata BM. Malakoplakia and primary immunodeficiency. J Pediatr 2014; 165:1053-6. [PMID: 25155967 DOI: 10.1016/j.jpeds.2014.07.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 05/21/2014] [Accepted: 07/16/2014] [Indexed: 11/24/2022]
Abstract
Malakoplakia, a rare granulomatous disease caused by impaired macrophage response, has been reported only rarely in children. We report 3 unique cases, with lesions occurring in unusual locations in children with primary immune deficiencies.
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Affiliation(s)
- Sydney R Archer
- Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA; Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA
| | - Carlos R Abramowsky
- Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA; Department of Pathology, Emory University School of Medicine, Atlanta, GA
| | - Lisa Kobrynski
- Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA
| | - Stephen Simoneaux
- Department of Pediatric Radiology, Emory University School of Medicine, Atlanta, GA
| | - Larry B Vogler
- Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA
| | - Richard R Ricketts
- Department of Pediatric Surgery, Emory University School of Medicine, Atlanta, GA
| | - Cecily Parker
- Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA
| | - Nancy Elawahbdeh
- Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA
| | - Bahig M Shehata
- Department of Pathology, Children's Healthcare of Atlanta, Atlanta, GA; Department of Pathology, Emory University School of Medicine, Atlanta, GA.
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Afonso JPJM, Ando PN, Padilha MHVDQ, Michalany NS, Porro AM. Cutaneous malakoplakia: case report and review. An Bras Dermatol 2014; 88:432-7. [PMID: 23793204 PMCID: PMC3754379 DOI: 10.1590/abd1806-4841.20131790] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 06/27/2012] [Indexed: 11/22/2022] Open
Abstract
Malakoplakia is a rare acquired disease that can affect many systems but is more common in the urogenital tract. Cutaneous malakoplakia is even rarer. It is far more frequent in immunodeficient patients. We report a case of cutaneous malakoplakia in a kidney transplant patient who had recently stopped receiving immunosuppressive therapy to illustrate a review of the relevant recent literature.
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21
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Histiocytic disorders of the gastrointestinal tract. Hum Pathol 2013; 44:683-96. [DOI: 10.1016/j.humpath.2012.05.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 05/12/2012] [Accepted: 05/16/2012] [Indexed: 12/27/2022]
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22
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Kang YJ, Kim SW, Lee KS, Kim KH. Malacoplakia of the epididymis. Korean J Urol 2013; 54:274-6. [PMID: 23614068 PMCID: PMC3630350 DOI: 10.4111/kju.2013.54.4.274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Accepted: 09/22/2011] [Indexed: 12/12/2022] Open
Abstract
Malacoplakia is a chronic inflammatory disease. The disease mainly affects the urinary bladder, although involvement of extravesical sites is increasingly being documented. Most frequently involved is the urinary tract, particularly the urinary bladder, although the testis, epididymis, lungs, bone, colon, prostate, female genital organs, and retroperitoneum can also be involved. Here we report the case of a 61-year-old man with a scrotal mass with histology that was specific for malacoplakia of the epididymis. The histologic workup demonstrated extensive involvement of the epididymis by diffuse infiltrates of large histiocytes with eosinophilic granular cytoplasm and numerous Michaelis-Gutmann bodies, which were diagnostic of malakoplakia. This is the first case of epididymal malacoplakia in our country and the first case of epididymal malacoplakia without concurrent involvement of the testis. There have been few reports of this condition worldwide.
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Affiliation(s)
- Yu Jin Kang
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
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23
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Lheureux S, Elie H, Michels JJ. [Malakoplakia associated with a colonic adenocarcinoma]. Ann Pathol 2012; 32:308-10. [PMID: 23010411 DOI: 10.1016/j.annpat.2012.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 07/04/2012] [Accepted: 07/05/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Stéphanie Lheureux
- Service d'oncologie médicale, centre François-Baclesse, avenue du-Général-Harris, 14000 Caen, France.
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Abstract
CONTEXT Specimens from the prostate and bladder are commonly encountered by the general surgical pathologist. Emphasis is usually placed on neoplasms of the bladder and prostate, particularly if malignant, owing to their therapeutic consequences. A good command of benign lesions occurring in the bladder and prostate, and knowledge of their preneoplastic potential will help pathologists confidently diagnose malignancy versus its benign mimickers and guide the urologists in choosing the appropriate therapy and follow-up for the patient. OBJECTIVE To present a mixture of benign entities, and discuss their histologic and clinical characteristics, hoping to provide a practical review for the general surgical pathologist. DATA SOURCES An extensive review of the literature on the entities discussed was performed. CONCLUSIONS A wide variety of benign entities are present in the prostate and bladder. Benign lesions in the prostate can be age related, such as prostatic atrophy and benign prostatic hyperplasia; transition zone associated, such as basal cell hyperplasia, adenosis, and sclerosing adenosis; or prostatic urethra associated. Benign lesions of the bladder encompass a wide variety of reactive changes that can occur in the urothelium, as well as hyperplastic lesions or reactive proliferations that could be misdiagnosed as malignant. The bladder responds to chronic irritation through several reactive/metaplastic lesions such as cystitis cystica/glandularis, keratinizing squamous metaplasia, or nephrogenic metaplasia. The urothelium can also give rise to hyperplastic/proliferative lesions, in particular von Brunn nest hyperplasia, papillary polypoid cystitis, and pseudocarcinomatous proliferation, which should be distinguished from malignant processes. Ectopic tissue, such as prostatic or mullerian, can also be seen.
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Affiliation(s)
- Lara Rabih Harik
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
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25
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[Case of renal parenchymal malakoplakia presenting as sepsis and treated with nephrectomy]. Nihon Hinyokika Gakkai Zasshi 2012; 102:721-5. [PMID: 22390086 DOI: 10.5980/jpnjurol.102.721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Malakoplakia is a rare chronic inflammatory condition characterized by defective macrophage function, most of which involve the genitourinary tract, and renal parenchymal involvement is uncommon. We present a case of malakoplakia affecting renal parenchyma. A 46-year-old woman with pyrexia and jaundice was referred to our department. Abdominal enhanced CT scan revealed a left pyelonephritis with ureteral stone and bilateral renal abscesses. Despite the insertion of a left ureteral stent and administration of antibiotics, the patient showed persistent high fever and elevated CRP, and no obvious improvement in clinical and imaging data. In view of the limited effectiveness of the conservative treatment in this case, we decided to perform left nephrectomy. The diagnosis of malakoplakia was made based on the histopathological findings of von Hansemann cells and Michaelis-Guttmann bodies detected in the nephrectomy specimen. She is clinically healthy up to the present (50 months after surgery) with normal clinical indicators and CT findings.
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Sekaran A, Dubale N, Lakhtakia S, Raju B, Ramchandani M, Darisetty S, Reddy DB, Reddy DN. Malakoplakia: an unusual cause of lower GI bleeding in a child. Gastrointest Endosc 2011; 74:443-5. [PMID: 21288516 DOI: 10.1016/j.gie.2010.11.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 11/19/2010] [Indexed: 02/08/2023]
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Görgel SN, Balcı U, Sarı AA, Ermete M, Girgin C, Dinçel Ç. Malakoplakia of the prostate diagnosed by elevated PSA level and transrectal prostate biopsy. Kaohsiung J Med Sci 2011; 27:163-5. [DOI: 10.1016/j.kjms.2010.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Accepted: 06/15/2010] [Indexed: 11/30/2022] Open
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La Malakoplakie Rétropéritonéale Pseudotumorale. AFRICAN JOURNAL OF UROLOGY 2010. [DOI: 10.1007/s12301-010-0015-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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29
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Sanchez LM, Sanchez SI, Bailey JL. Malacoplakia presenting with obstructive nephropathy with bilateral ureter involvement. Nat Rev Nephrol 2009; 5:418-22. [PMID: 19556995 DOI: 10.1038/nrneph.2009.86] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND A 48-year-old woman with chronic urinary tract infections presented with uremia. Imaging studies revealed bilateral hydronephrosis and segmental ureteral thickening. INVESTIGATIONS Physical examination, urine and blood analysis, radiography of the chest, chest CT, abdominal and pelvis CT, renal ultrasonography, cystoscopy, anterograde pyelogram, bladder biopsy. DIAGNOSIS Malacoplakia involving bilatateral ureters and bladder; cavitary pneumonia. MANAGEMENT Hemodialysis, placement of bilateral percutaneous nephrostomy tubes, administration of ciprofloxacin, ascorbic acid and bethanechol.
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Affiliation(s)
- Lorin M Sanchez
- Emory University School of Medicine, Renal Division, Atlanta, GA 30322-2525, USA.
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30
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Oladipo A, Somaiya P, Kassab A, Liddicoat A, Mathew J. A rare case of pelvic malakoplakia mimicking advanced cervical cancer infiltrating the bladder. J OBSTET GYNAECOL 2009; 27:749-51. [DOI: 10.1080/01443610701630815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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31
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Pseudotumoral malacoplakia of the bladder. AFRICAN JOURNAL OF UROLOGY 2009. [DOI: 10.1007/s12301-009-0016-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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32
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Dhabalia JV, Nelivigi GG, Jain NK, Suryavanshi M, Kakkattil S. Malakoplakia of the ureter: An unusual case. Indian J Urol 2009; 24:261-2. [PMID: 19468409 PMCID: PMC2684280 DOI: 10.4103/0970-1591.40627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Malakoplakia of the ureter is a rare pathological entity. We discuss a 15-year-old girl with malakoplakia of the ureter. She presented with obstructive uropathy associated with left flank pain. Radiological investigations showed left lower ureteric stricture without bladder or kidney involvement. She was treated by excision of terminal ureter and ureteroneocystostomy. Histopathologic examination of the excised specimen showed malakoplakia. Postoperative course was uneventful and on follow-up, she has normal serum creatinine and no recurrence of the disease.
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Affiliation(s)
- Jayesh V Dhabalia
- Department of Urology, KEM Hospital and Seth GS Medical College, Parel, Mumbai - 400 012, India
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Diapera MJ, Lozon CL, Thompson LD. Malacoplakia of the tongue: a case report and clinicopathologic review of 6 cases. Am J Otolaryngol 2009; 30:101-5. [PMID: 19239951 DOI: 10.1016/j.amjoto.2008.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 02/19/2008] [Accepted: 02/26/2008] [Indexed: 01/27/2023]
Abstract
BACKGROUND Extra-urogenital tract malacoplakia is uncommon, with tongue malacoplakia being exceptionally rare. The nonspecific clinical presentation and variable histologic patterns can make recognition of this lesion and separation from other lesions challenging. There are only a few reported cases in the English literature. MATERIALS AND METHODS Five case reports of tongue malacoplakia were compiled from the literature (MedLine 1960-2008) and integrated with this case report. RESULTS The patients included 4 males and 2 females, ranging in age from 9 to 98 years (mean, 64 years). Patients presented with difficulty swallowing, foreign body sensation, a mass lesion, or referred pain (neck or ear). Symptoms were present from a few days up to 18 months. The base of the tongue was the most frequent site, although midline tongue and half of the tongue were also affected. Radiographic studies demonstrated a mass, with a single lesion showing positron emission tomography positivity. Two patients had previous cancers (prostate and colorectal; larynx). This case report was a farm hand for horses, with gram-negative rods, suggestive of Rhodococcus equi identified. The lesions were 1 to 2 cm in greatest dimension. Histologically, there is pseudoepitheliomatous hyperplasia or ulceration with a heavy acute and chronic inflammatory infiltrate. The subepithelial spaces are completely filled with eosinophilic histiocytes, most of which contain granular material in their cytoplasm. Well-formed, blue, calcific bodies are noted, a few showing a "targetoid appearance" and concentric lamination. These Michaelis-Gutmann bodies are positive with von Kossa, iron, and periodic acid-Schiff stains. These findings support a diagnosis of malacoplakia. The differential diagnosis includes granular cell tumor, poorly differentiated carcinoma, and Langerhans histiocytosis. Patients are managed with antibiotic therapy and excision. CONCLUSIONS Tongue malacoplakia is rare, often presenting as a mass lesion. Histologic recognition of this abnormal phagocytic disorder will prevent potentially disfiguring surgery.
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Abstract
Benign diseases of the bladder often present diagnostic challenges to practicing pathologists due to their diverse nature and ability to mimic a variety of epithelial or mesenchymal neoplasms. Categories of benign bladder disease include infectious cystitis, noninfectious cystitis, reactive proliferative processes, and benign processes that secondarily involve the bladder. An understanding of the key clinical and morphologic features of these lesions and the useful ancillary techniques specific for these entities is critical to the correct diagnosis of these lesions. This article reviews the key features of these benign bladder diseases and highlights methods to distinguish these lesions from other benign and malignant processes involving the bladder.
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Affiliation(s)
- Joshua F Coleman
- Department of Anatomic Pathology, The Cleveland Clinic, 9500 Euclid Avenue, Desk L25, Cleveland, OH 44195, USA
| | - Donna E Hansel
- Department of Anatomic Pathology, Glickman Urological and Kidney Institute, Taussig Cancer Institute, The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, The Cleveland Clinic, 9500 Euclid Avenue, Desk L25, Cleveland, OH 44195, USA.
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Krauel L, García-Aparicio L, Pérez N, Laguna A, Camacho A, Vilar P, Rodó J, Ribó JM. Urinary and gastrointestinal malakoplakia in a 12-year-old girl. Urology 2008; 73:87-9. [PMID: 18952264 DOI: 10.1016/j.urology.2008.05.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Revised: 04/15/2008] [Accepted: 05/15/2008] [Indexed: 11/30/2022]
Abstract
Malakoplakia is a rare chronic inflammatory disease that was originally described in the urinary bladder but can involve many other organs and soft tissues. It is believed to be caused by an alteration in the bacterial phagocytic system. Clinically, it is described as single or multiple tumors that can appear in any part of the body. Histologically, the presence of Michaelis-Gutmann bodies is pathognomonic. Malakoplakia in children is rare. Few pediatric cases in the urinary tract, kidney, or gastrointestinal tract have been published. We present a case of urinary and gastrointestinal malakoplakia in a 12-year-old girl.
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Affiliation(s)
- Lucas Krauel
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
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36
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Bylund J, Pais VM. A case of acute renal failure caused by bilateral, multifocal malacoplakia lesions of the bladder and ureters. ACTA ACUST UNITED AC 2008; 5:516-9. [PMID: 18679396 DOI: 10.1038/ncpuro1173] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Accepted: 06/18/2008] [Indexed: 11/09/2022]
Abstract
BACKGROUND A 51-year-old woman with a history of hypertension and a 5-year history of recurrent perimenopausal Escherichia coli urinary tract infections presented with fatigue. She had a history of occasional urinary frequency, but denied gross hematuria, flank pain, abdominal pain, immunodeficiency or immunosuppression. INVESTIGATIONS Basic metabolic profile, ultrasonography, cystoscopy, retrograde pyelography, pathologic evaluation of resected lesions from the bladder, ureteroscopy, pathologic evaluation of resected lesions from the ureters, and MRI. DIAGNOSIS Acute renal failure caused by bilateral, multifocal malacoplakia lesions of the bladder and ureters. MANAGEMENT Endoscopic resection and laser ablation, ureteral stent placement, and medical treatment with fluoroquinolones, vitamin C and bethanechol.
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Affiliation(s)
- Jason Bylund
- Department ofSurgery, Division of Urology, University of Kentucky Chandler Medical Center, Lexington, KY, USA
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37
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Colonic malakoplakia in a liver transplant recipient. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2008; 21:753-5. [PMID: 18026580 DOI: 10.1155/2007/256031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Malakoplakia is a rare inflammatory condition seen in transplant patients. There are two previously reported cases of malakoplakia involving the gastrointestinal tract in liver transplant patients. The present paper reports a case of colonic malakoplakia in a 58-year-old woman, a liver transplant recipient who was receiving immunosuppressive drugs. She presented with chronic diarrhea while on tacrolimus. There was no history of antecedent infection. Colonoscopy showed patchy mucosal edema, but no discrete yellow plaques or nodules. The diagnosis was made by colon biopsies, which showed chronic inflammation with many histiocytes containing Michaelis-Gutmann bodies. Although rare, malakoplakia is one of many potential causes of diarrhea in a transplant patient. The present case indicates that malakoplakia may be associated with chronic diarrhea, even if there are no macroscopic lesions seen during colonoscopy.
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38
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Inoue T, Nishiyama H, Yoshimura K, Ito N, Kamoto T, Habuchi T, Ogawa O. Solitary upper ureteral malakoplakia successfully diagnosed by ureteroscopic biopsy and treated conservatively. Int J Urol 2007; 14:859-61. [PMID: 17760757 DOI: 10.1111/j.1442-2042.2007.01825.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Malakoplakia of the urinary tract is a granulomatous inflammatory disease due to bacterial infection and can usually be treated conservatively, whereas all of the past reported patients with solitary ureteral malakoplakia underwent surgical excision. We report a patient with solitary isolated upper ureteral malakoplakia that was successfully diagnosed by ureteroscopic biopsy. After conservative treatment with levofloxacin, bethanechol chloride and ascorbic acid, her right hydronephrosis and the lesion were reduced for more than six months.
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Affiliation(s)
- Takamitsu Inoue
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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39
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40
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Weinrach DM, Wang KL, Cisler JJ, Diaz LK. Pathologic Quiz Case: A 54-Year-Old Liver Transplant Recipient With Diffuse Thickening of the Sigmoid Colon. Arch Pathol Lab Med 2004; 128:e133-4. [PMID: 15387686 DOI: 10.5858/2004-128-e133-pqcayl] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- David M Weinrach
- Department of Surgical Pathology, Feinberg School of Medicine, Northwestern University, Northwestern Memorial Hospital, Chicago, Ill 60611, USA.
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41
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Muzaffar S, Yaqoob N, Jafri N, Kayani N, Ahmad Z. Clinical quiz. Malakoplakia of rectum and anal canal in childhood. J Pediatr Gastroenterol Nutr 2003; 37:570, 603. [PMID: 14640096 DOI: 10.1097/00005176-200311000-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Suhail Muzaffar
- Department of Pathology, Faculty of Health Sciences, The Aga Khan University, Karachi, Pakistan
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42
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Répássy DL, Iványi A, Csata S, Tamás G. Combined occurrence of prostate carcinoma and malacoplakia. Pathol Oncol Res 2003; 8:202-3. [PMID: 12516002 DOI: 10.1007/bf03032396] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2001] [Accepted: 07/15/2002] [Indexed: 10/21/2022]
Abstract
This is a case of a 56-year-old male patient suffering from a combination of prostate carcinoma and malacoplakia. A 56-year-old male patient was admitted in our Department because ischuria due to the enlargement of the prostate. Perineal needle biopsy was done resulting carcinoma of prostate. Radical prostatectomy was performed. Histology proved carcinoma and a great part of the enlarged prostate consisted of malacoplakia. Questions related to the morphology, tissue structure as well as diagnosis are briefly surveyed. This is the first report on the rarely occurring combination of prostate carcinoma and malacoplakia treated by radical retropubic prostatectomy.
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Ben Amna M, Hajri M, Oumaya C, Anis J, Bacha K, Ben Hassine L, Chebil M, Ayed M. [Genito-urinary malacoplakia. Report of 10 cases and review of the literature]. ANNALES D'UROLOGIE 2002; 36:388-91. [PMID: 12611142 DOI: 10.1016/s0003-4401(02)00137-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The malakoplakia is a rare and benign disease. Its urinary localisation is commonly known. It has no clinical particularity. The diagnosis is histological. The physiopathology is infectious associated with a local macrophage function failure. The treatment associates antibiotic and colinergic drugs. Surgical removal is necessary only when the organ is destroyed. We report 10 cases of urinary malakoplakia with 4 renal localisation's causing pyonephrosis in the majority of cases, 3 prostatic localisation's that were wrongly considered as prostatic adénocarcinoma after a rectal examination and finally 3 testicular localisation's causing a necrotic destruction of the testis. The urinalysis was positive in 4 cases. We did 4 kidney removals, 3 endoscopic prostatic resections and 3 testis removals. The diagnosis was made by the histological examination of the surgical products.
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Affiliation(s)
- Aaron Sulman
- Department of Urology, Case Western Reserve University School of Medicine/University Hospitals of Cleveland, Cleveland, Ohio 44106-5046, USA
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Gray Y, Libbey NP. Xanthogranulomatous salpingitis and oophoritis: a case report and review of the literature. Arch Pathol Lab Med 2001; 125:260-3. [PMID: 11175647 DOI: 10.5858/2001-125-0260-xsao] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A case of xanthogranulomatous salpingitis and oophoritis in a 47-year-old woman is presented. Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to affected organs; it is characterized by the presence of lipid-filled macrophages with admixed lymphocytes, plasma cells, and neutrophils. Only a few cases of xanthogranulomatous salpingitis and oophoritis have been reported to date. The case presented here is associated with Escherichia coli infection, endometriosis, and an intrauterine device.
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Affiliation(s)
- Y Gray
- Department of Pathology, Rhode Island Hospital and Brown University School of Medicine, Providence, RI, USA
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Love KD, Chitale SV, Vohra AK, Ball RY. Urethral stricture associated with malacoplakia: a case report and review of the literature. Urology 2001; 57:169. [PMID: 11164174 DOI: 10.1016/s0090-4295(00)00898-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 68-year-old man presented with obstructive and irritative lower urinary tract symptoms and microscopic hematuria. Cystourethroscopy showed a circumferential stricture in the bulbar urethra that bled easily on contact. Biopsy revealed malacoplakia. There was also focal nonspecific cystitis. The patient improved symptomatically, but the microscopic hematuria persisted. Follow-up biopsies showed persistent urethral malacoplakia and stricture. Malacoplakia of the male urethra is exceptionally rare, this being the second reported case.
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Affiliation(s)
- K D Love
- Department of Histopathology/Cytopathology, Norfolk & Norwich Hospital, Norfolk, United Kingdom
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 31-2000. A 32-year-old man with a lesion of the urinary bladder. N Engl J Med 2000; 343:1105-11. [PMID: 11027746 DOI: 10.1056/nejm200010123431508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Evans NL, French J, Rose MB. Renal malacoplakia: an important consideration in the differential diagnosis of renal masses in the presence of Escherichia coli infection. Br J Radiol 1998; 71:1083-5. [PMID: 10211070 DOI: 10.1259/bjr.71.850.10211070] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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.
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Affiliation(s)
- N L Evans
- Department of Radiology, Morriston Hospital NHS Trust, Swansea, UK
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Kostakopoulos A, Giannakopoulos S, Demonakou M, Deliveliotis C. Malakoplakia of the testis. Case report. Int Urol Nephrol 1998; 30:311-2. [PMID: 9696338 DOI: 10.1007/bf02550315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Malakoplakia of the testis presenting as painless enlargement of the testis in an 80-year-old man is described. The literature is reviewed.
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Affiliation(s)
- A Kostakopoulos
- Department of Urology, Sismanoglion Hospital, University of Athens Medical School, Greece
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