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At least 19 recordsLinked to original sources
PubMed1983

Prostatic malacoplakia: a case report with a review of 49 cases of malacoplakia of various sites in Japan.

We reported a 62-year-old man with malacoplakia of the prostate, and reviewed 49 cases of malacoplakia hitherto observed in Japan in which the lesions originated from the urogenital tract, except for one gastric case. E. Coli was emphasized as a possible causative agent for malacoplakia especially in the urogenital tract. The possible histiocytic origin of von Hansemann cells was stressed by demonstrating cytoplasmic processes and desmosomes in our prostatic case. An adjuvant use of cholinergic agents and ascorbic acid with chemotherapeutic agents was recommended for treating malacoplakia.

Histiocytes↗
PubMed1998

Malacoplakia in a colonic adenoma: case report.

We report a case of colonic malacoplakia in a tubular adenoma. A 67-year-old neurotic man had been treated with minor tranquilizers for 10 years. In January 1997, he underwent a health examination. Most of the tests performed were within normal limits, except the colonoscopy, which revealed a polypoid lesion in the left colon. A polypectomy was performed at that time. The histopathological study of the polyp showed a tubular adenoma with malacoplakia, characterized by an aggregate of numerous histiocytes containing Michaelis-Gutmann bodies in the lamina propria. A review of the English literature indicated that 35 cases of colonic malacoplakia have been documented. Colonic malacoplakia can occur in isolation or with diffuse or multiple involvement of the adjacent and unrelated diseased sites. The majority of cases are associated with other diseases, the most common being carcinoma of the colorectum. The association of colonic malacoplakia with adenoma is extremely rare and only 3 cases including our present case have been reported. We suggest that colonic malacoplakia is more common than usually suspected. A careful histologic examination is necessary.

Adenoma↗
PubMed1984

Malacoplakia associated with vesicoureteral reflux and selective immunoglobulin A deficiency.

A case of malacoplakia involving the lower urinary tract of a young black boy, with associated bilateral vesicoureteral reflux, hydronephrosis and selective immunoglobulin A deficiency is reported. Reflux was caused by the malacoplakia. Reflux and hydronephrosis persisted despite elimination of bacterial infection and malacoplakia by drug therapy. These abnormalities were corrected by a conventional antireflux operation. Malacoplakia appears to be related to immunologic incompetence and diminished levels of intracellular cyclic 3',5' guanine monophosphate. Cholinergic agonists reverse or prevent the pathological changes of malacoplakia.

Anti-Infective Agents, Urinary↗
PubMed1994

Bilateral renal parenchymal malacoplakia presenting as fever of unknown origin: case report and review.

Malacoplakia is a rare inflammatory disorder seen most often in the urinary tract, where it is highly associated with coliform infection. Although first recognized by pathologists in 1902, it has received little attention from the infectious disease community. While there remains much uncertainty regarding the specific cause of malacoplakia, it appears to be associated with a defect in intracellular killing of ingested microorganisms by macrophages. We report a case of bilateral renal parenchymal malacoplakia that presented as fever of unknown origin, and we review 33 previously identified cases. Renal malacoplakia has traditionally been associated with high morbidity and mortality. More recently, treatment with antimicrobial agents such as trimethoprim or ciprofloxacin has yielded a better outcome than had been documented with other therapy. Malacoplakia should be considered in the evaluation of fever of unknown origin or of relapsing or refractory urinary tract infection. Therapy with antimicrobial agents capable of intracellular penetration is recommended.

Anti-Infective Agents↗
PubMedDate not supplied

Colonic malacoplakia: unusual association with ulcerative colitis.

A 44 year old Chinese female with malacoplakia of the colon associated with ulcerative colitis was presented. The patient showed typical histological, electron microscopic and X-ray micro-analysis findings of malacoplakia. The malacoplakia gradually disappeared after discontinuation of high-dose systemic steroid prescribed by private practitioner for the ulcerative colitis. A review of the 26 previously reported cases of malacoplakia of the colon is also included. Coupled with the clinical events of this patient, it appears that malacoplakia is likely to be secondary to immunosuppression, due to drugs, malignant or debilitating diseases.

Adult↗
PubMed1995

Antigenicities of enteropathogenic Escherichia coli, lysozyme, and alpha-1-antichymotrypsin on macrophages of genitourinary malacoplakia.

Seven cases of genito-urinary malacoplakia were analyzed histologically, ultrastructurally and immunohistochemically in a comparison with two cases of xanthogranulomatous pyelonephritis. Immunohistochemically, von Hansemann cells and Michaelis-Guttmann bodies, both hallmarks for the diagnosis of malacoplakia, showed a common antigenicity for enteropathogenic Escherichia coli as cytoplasmic granules of varying sizes. These microscopic manifestations corresponded ultrastructurally to a series of phagolysosomal degradations of coliform bacilli. Serogroups against E. coli OK antigens, which were positive for malacoplakic cells, were not confined to a particular group. Macrophages of xanthogranulomatous pyelonephritis did not show the E. coli antigenicity. Antigenicity of lysozyme and alpha-1-antichymotrypsin on the von Hansemann cells was equivocal, but these enzymes were strongly positive on macrophages of xanthogranulomatous pyelonephritis. The macrophages of both malacoplakia and xanthogranulomatous pyelonephritis were positive for antihuman macrophage antibody. These results indicate that malacoplakia depends mainly on infection by a non-specific strain of enteropathogenic E. coli and may arise from defective digestive enzyme activity of infiltrating macrophages. Immunohistochemical analysis using antisera against E. coli OK antigens, lysozyme and alpha-1-antichymotrypsin was useful in identifying the prediagnostic stage of malacoplakia and in differentiating the lesion from xanthogranulomatous pyelonephritis.

Adult↗
PubMedDate not supplied

Fine needle aspiration cytology of malacoplakia of the thyroid. A case report.

BACKGROUND: Malacoplakia was first described by Michaelis and Gutmann in 1902 and further characterized by Von Hansemann, who coined the term malacoplakia to describe the soft, yellow-tan, raised plaques he encountered in a case involving the urinary bladder.11 CASE: Fine needle aspiration cytology of a case of malacoplakia of the thyroid gland was performed on a 60-year-old woman. Fine needle aspiration demonstrated histiocytes with abundant granular cytoplasm that were eosinophilic with hematoxylin-eosin stain. Many of the cells contained numerous round, regular-appearing inclusions, which ranged in size from 4 to 10 microns in diameter. Many of these inclusions demonstrated the characteristic concentric appearance of Michaelis-Gutmann bodies. The inclusions were strongly positive for periodic acid-Schiff stain and stained weakly with Von Kossa stain. Clinically and radiologically the lesion mimicked a malignant neoplasm by virtue of its large size and destruction of adjacent cervical vertebrae. The diagnosis was ascertained only after surgical excision. CONCLUSION: This is the first report of fine needle aspiration cytology of malacoplakia of the thyroid. The case demonstrates how difficult it may be to diagnose this rare entity, regardless of its characteristic features. It also underscores the point that malacoplakia may occur anywhere in the body and should always be considered when round, concentric intracytoplasmic inclusions are seen within histiocytes.

Biopsy, Needle↗
PubMed1993

[Testicular malacoplakia. Case report].

Testicular malacoplakia is an extremely rare condition; only 37 cases have been reported in the world literature. We hereby report a case of testicular malacoplakia. In over half of the cases of testicular malacoplakia, a preceding bacterial infection of a gram-negative rod has been known to occur, most commonly. Escherichia coli from urine or a suppurative lesion. This evidence may well be significant in explaining a possible initiative or contributing cause of malacoplakia. Orchiectomy is thought necessary to distinguish testicular malacoplakia from other scrotal conditions such as testicular cancer and granulomatous orchitis.

Diagnosis, Differential↗
PubMed2001

[Urogenital malacoplakia. Report of 4 cases and review of the literature].

OBJECTIVE: To review the subject of malacoplakia and analyze the incidence of urinary and genital, and extra-urinary localizations. METHODS: We reviewed the literature on urinary and extra-urinary malacoplakia. Our series of 4 cases are presented (two renal, one prostatic with uncommon clinical presentation and one of the urinary bladder). RESULTS: This study confirms that there is an increasing proportion of extravesical involvement in malacoplakia of the urinary tract and extra-urinary localization involving practically all the organs and organ systems. CONCLUSIONS: 614 cases of malacoplakia have been reported; of these, 60.4% were urinary and 39.5% extra-urinary (including retroperitoneal localization). Renal involvement, if we include the bilateral forms and those occurring in the transplanted kidneys, is equal in number to the cases localized to the bladder. Although malacoplakia is a "benign" condition, the prognosis of the bilateral forms involving the upper urinary tract and those occurring in the transplanted kidney appears to be poor, with a mortality rate of 20%-50%. Furthermore, this review clearly shows the need for follow-up in these patients since "recurrences" have been reported at different levels of the urinary tree up to 10 years after the initial diagnosis.

Aged↗
PubMed2002

Malacoplakia of the tongue. A case report and review of the literature.

Our aim is to present a singular case of malacoplakia of the tongue and a review of the literature. Malacoplakia (from the Greek "malacos", soft, and "placos", plaque) is a granulomatosis initially described in 1902. It has the clinical aspect of a yellow-brown, soft plaque of variable size, characterized by a central navel or ulcer and an intense peripheral hyperaemia, usually located in the urogenital and gastrointestinal tract. The mortality rate is higher than 50% if vital organs are involved. In the world literature there are 16 cases of the head and neck region and particularly only 2 of them are located on the tongue. In these 2 cases the lesion caused some distress to the patients who referred to a medical observation for this motive. Conversely we report a case of asymptomatic lingual malacoplakia occurring in a 57-year-old woman, diagnosed by chance during a stomatological examination in the Department of Oral Medicine and Periodontology of Turin University. In this case the outcome was quite plain and our patient did not need any supporting medical therapy. Nevertheless the potential danger of malacoplakia should underline the importance of a more careful histological assessment of submucosal nodules of the oro-pharyngeal region. Moreover the histopathological characteristic, the present etiopathogenetic hypothesis and the therapeutic pattern of malacoplakia suggested in the literature are discussed.

Female↗
PubMed1978

[Clinical and morphological findings and problems in malacoplakia of the urinary bladder (author's transl)].

Malacoplakia of the urinary bladder (observations on 4 female patients, average age 47 years, longest duration 8 years) is, under light microscopy, arranged in 4 layers. Zone 1 contains inflammatory granulation tissue. Zone 2 is composed of von Hansemann cells (macrophages). In zone 3, Michaelis-Gutmann bodies appear. Finally, the deepest zone 4 contains connective tissue, blood vessels, and lymphoplasmacellular infiltrates. By electron microscopy, the gradual formation of residual bodies from the remains of phagocytosed materials in the macrophages in these layers can be observed. Through loading with calcium and iron compounds, the residual bodies take on the characteristic appearance of Michaelis-Gutmann bodies. Etiologically, the origin of malacoplakia is probably involved with coliform bacteria, but apparently additional factors are required for the development of a disease process: e.g., disturbance of macrophage function. There are certain parallels between malacoplakia and Whipple's disease. With atypical localization outside the urinary bladder, differential diagnostic difficulties can arise in separating malacoplakia from inflammatory-granulomatous processes (granulomatous orchitis, xanthogranulomatous pyelonephritis). The prognosis of malacoplakia in the urinary bladder is good in all cases, but timely treatment of recurrence and constant supervision are indicated.

Adult↗
PubMed1996

Malacoplakia. Two case reports and a comparison of treatment modalities based on a literature review.

Malacoplakia is a rare infectious disease that has been almost exclusi vely reported in urology and pathology journals. We studied two cases of malacoplakia that were primarily referred to the department of internal medicine because of fever and abdominal masses. In one patient, malacoplakia was diagnosed in the unusual ovarian location, while in the other patient a large renal mass was found and ciprofloxacin therapy failed because of bacterial resistance. The clinical and radiologic appearance of malacoplakia often mimics that of a malignant tumor. The principal disorder is probably a monocytic-macrophagic bactericidal defect. A definitive diagnosis depends on microscopic detection of Michaelis-Gutmann bodies by means of von Kossa stain. We outlined treatment strategies on the basis of a review of the literature since 1981, which included 140 cases. If possible, immunosuppressive drugs should be stopped. Quinolone antibiotic treatment and surgical excision or incision and drainage lead to the highest cure rates (90% and 81%, respectively). Specific intracellular penetration of quinolone antibiotics is a possible reason for the higher cure rate achieved with these antibiotics. Bethanechol has been suggested to correct the supposed fundamental disturbance by increasing the intrecellular cyclic guanosine monophosphate concentration, but there is still no convincing evidence of its clinical efficacy.

Adult↗
PubMed2001

Malacoplakia simulating organ invasion in a rectosigmoid adenocarcinoma: report of a case.

Malacoplakia is a histiocytic inflammatory response that may be associated with colorectal tumors. We report the case of a 65-year-old male taking steroids for a severe pulmonary disease. He presented with a rectosigmoid tumor that seemed to infiltrate the urinary bladder and the sacrum on the preoperative CT scan and echography and at laparotomy. A low anterior resection en bloc with a partial cystectomy was performed. The pathologic analysis showed a pT3pN0 adenocarcinoma with an extensive malacoplakia infiltrating the bladder and the pericolic and perirectal tissues. This case report emphasizes the overstaging that malacoplakia may induce and underlines a situation the surgeon may possibly confront. Our observation confirms the association of malacoplakia, colorectal carcinoma, and steroid treatment.

Abdominal Pain↗
PubMed1985

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.

Abdomen↗
PubMed1979

Malacoplakia of the bladder: efficacy of bethanechol chloride therapy.

Present evidence suggests that malacoplakia is the result of a functional defect in the mononuclear cells of the lesion caused by a deficiency of cyclic 3',5' guanosine monophosphate. This defect results in the impaired ability of the macrophage to release lysosomal enzymes necessary for the digestion of phagocytized bacteria. The persistent inflammatory reaction produces the characteristic granuloma of malacoplakia. Previous laboratory studies indicate that the phagocytic defect is reversible by cholinergic agonists, which led to the use of bethanechol chloride in the treatment of patients with malacoplakia. We report on 3 patients with vesical malacoplakia who were treated successfully with bethanechol chloride.

Adult↗
PubMed1994

Pulmonary malacoplakia associated with Rhodococcus equi infection in a patient with acquired immunodeficiency syndrome.

Pulmonary malacoplakia associated with Rhodococcus equi, an opportunistic Gram-positive coccobacillus, is unusual. Although this patient is the ninth reported to have pulmonary malacoplakia, he is only the third patient with the acquired immunodeficiency syndrome who has been reported to have pulmonary malacoplakia associated with R equi infection. The patient was a 49-year-old man infected with the human immunodeficiency virus who on initial examination was found to have cavitary pneumonia in the right upper lobe of the lung. Histologic examination of an open-lung biopsy specimen revealed sheets of foamy intraalveolar macrophages that contained coccobacillary organisms and some "targetlike" cytoplasmic inclusions. Electron-microscopic studies showed Michaelis-Gutmann bodies, some of which contained residual bacterial fragments. Cultures of the lung tissue, urine, and blood yielded growth of Gram-positive coccobacilli subsequently identified as R equi. In immunocompromised patients, the possibility of malacoplakia should be considered in the differential diagnosis of diffuse pulmonary infiltrate composed of foamy intraalveolar macrophages.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Malacoplakia of the epididymis. Report of a case and review of the literature.

A 65-year-old diabetic man presented with a painful swelling of his right epididymis. Urine culture was sterile. Semicastration was performed and histology revealed malacoplakia of the epididymis without involvement of the testis. Histologic workup demonstrated typical von Hansemann cells and Michaelis-Gutmann bodies stained by von Kossa's stain. This is the 19th case of epididymal malacoplakia and the 9th case of epididymal malacoplakia without concurrent involvement of the testis. Literature review shows that the present case is typical with respect to the clinical presentation and with regard to the age of presentation. The fact that this patient was suffering from diabetes mellitus lends some support to the assumption that a compromised immune status could be etiologic in malacoplakia.

Aged↗