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Taher M, Shahsia R, Ebrahimi Daryani N. Malakoplakia as a Rare Cause of Diarrhea: Case Presentation and Review of Literature. Middle East J Dig Dis 2021; 13:71-74. [PMID: 34712442 PMCID: PMC8531935 DOI: 10.34172/mejdd.2021.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/13/2020] [Indexed: 11/28/2022] Open
Abstract
Colonic malakoplakia is a rare chronic granulomatous disease that can involve many organs such as the lung, brain, pancreas, bone, adrenal glands, and genitourinary tract. The most common site of involvement outside the genitourinary tract is the gastrointestinal tract. We report a case of colonic malakoplakia who presented with unintentional weight loss, abdominal pain, and chronic diarrhea. There was a history of lupus nephritis and Sjogren disease, receiving various immunosuppressive drugs. Physical examination other than pallor was unremarkable in this patient, but colonoscopy revealed multiple polyps in the rectum with a cobblestone appearance in the cecum. The histopathological assessment showed infiltration of numerous lymphoplasma cells and neutrophils in the lamina propria, and rare Michaelis-Gutmann bodies were seen in foamy epithelioid histiocytes. These findings are suggestive of malakoplakia. We treated the patient with tetracycline, and after 3 months of follow-up, clinical improvement was achieved.
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Affiliation(s)
- Mohammad Taher
- Assistant Professor of Gastroenterology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Shahsia
- Associate Professor of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasser Ebrahimi Daryani
- Professor of Gastroenterology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Jeong JW, Noh JH, Kang JH, Park JH, Lee JH. Cecal malakoplakia: A case report. KOREAN JOURNAL OF CLINICAL ONCOLOGY 2021; 17:44-47. [PMID: 36945214 PMCID: PMC9942739 DOI: 10.14216/kjco.21007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 11/07/2022]
Abstract
Malakoplakia is a rare chronic granulomatous disease found in the genitourinary tract, mainly. It is considered to be related to immunosuppression and/or infectious processes. We would like to present an operative case of cecal malakoplakia in a patient with a history of surgical resection and chemotherapy for cervical cancer. A 74-year-old female patient visited our hospital for 1-year follow-up after operation and chemo-radiotherapy for cervical cancer. An infiltrative mass of 6 cm, between the cecal base and the right psoas muscle, was observed on computed tomography. An ileocectomy was performed for diagnosis. Histopathologic examination revealed cecal malakoplakia. After surgery, based on previous reports, antibiotics therapy was added. Then the patient was discharged and treated in the outpatient clinic. To our knowledge, a rare case has been described of cecal malakoplakia during observation after surgery and chemo-radiotherapy for cervical cancer. Malakoplakia is known to be related to immunosuppressive condition. Therefore, our case suggests that close observation should be made in patients on immunosuppressive condition, such as chemotherapy.
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Affiliation(s)
- Jin Woon Jeong
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyun Noh
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Hyun Kang
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyun Park
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Hyung Lee
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Achufusi TG, Jessamy K, Chebaya P, Rawlins S. Rectal malakoplakia. Proc (Bayl Univ Med Cent) 2020; 33:389-390. [PMID: 32675959 DOI: 10.1080/08998280.2020.1764317] [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: 04/01/2020] [Revised: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022] Open
Abstract
Malakoplakia is a rare chronic granulomatous disease with potential to affect multiple organs. Gastrointestinal involvement is considered one of the most common locations outside of the urinary tract. Herein, we present the case of a man who presented to our clinic with painless hematochezia. Physical examination findings were unremarkable; however, colonoscopy revealed a frond-like/villous, fungating, and polypoid nonobstructing circumferential mass in the rectum. Histopathological examination of the lesion revealed findings consistent with malakoplakia.
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Affiliation(s)
- Ted George Achufusi
- Department of Internal Medicine, State University of New York Upstate Medical UniversitySyracuseNew York
| | - Kegan Jessamy
- Department of Internal Medicine, State University of New York Upstate Medical UniversitySyracuseNew York
| | - Philip Chebaya
- Department of Internal Medicine, State University of New York Upstate Medical UniversitySyracuseNew York
| | - Sekou Rawlins
- Department of Gastroenterology, State University of New York Upstate Medical UniversitySyracuseNew York
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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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