malakoplakia


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mal·a·co·pla·ki·a

, malakoplakia (mal'ă-kō-plā'kē-ă, mal'a-kō-plā'kē-a),
Rare lesion in the mucosa of the urinary bladder and other organs, more frequent in women, characterized by numerous mottled yellow and gray soft plaques and nodules that consist of numerous macrophages and calcospherites (Michaelis-Guttmann bodies) that may form around intracellular bacteria, usually Escherichia coli.
[malaco- + G. plax, plate, plaque]

malakoplakia

A rare (less than 500 cases in the world literature) granulomatous lesion characterised by soft, yellow, elevated and friable 3–4 cm mucosal plaques of the genitourinary tract (bladder, renal pelvis, ureter, uterus, broad ligament, endometrium, testes, epididymis, prostate), with female:male ratio of 2.3:1 and, rarely, retroperitoneum, colon, stomach, appendix, lymph nodes, lungs, bone, skin. It is more common in immunosuppressed transplant recipients, a complication of recurrent infection, and attributed to defective phagocytosis. It may be associated with colorectal carcinoma.

Management
Long-term antibiotics, ascorbic acid, cholinergics; if recalcitrant, excision.

malakoplakia

malakos, Greek, soft plaque A lesion characterized by soft, yellow, elevated and friable 3-4 cm mucosal plaques of the GU tract–bladder, renal pelvis, ureter, uterus, broad ligament, endometrium, testes, epididymis, prostate and rarely, retroperitoneum, colon, stomach, appendix, lymph nodes, lungs, bone, skin; more common in immunosuppressed transplant recipients Treatment Long-term antibiotics, ascorbic acid, cholinergics; if recalcitrant, excision
References in periodicals archive ?
Malakoplakia: evidence for an acquired disease secondary to immunosuppression.
These are Tuberculous granulomas, Lepromatous granulomas, Foreign Body granulomas, Necrobiotic granulomas, Suppurative granulomas, Sarcoidal granulomas and Xanthgranulomas/ malakoplakia. 6-8
Keeping in view the findings of microscopic examination and results of special stains, a diagnosis of malakoplakia was made.
Some scholars pointed out that in malakoplakia, macrophage dysfunction and persistent antigens within cells cause progressive delivery of cytokines, resulting in renal inflammation and further injury.[sup][3] If the early interstitial injury is not controlled, renal injury continues to deteriorate and even processes to interstitial fibrosis even though bacteria are removed.[sup][4] To date, there are only very few case reports concerning antibiotics plus corticosteroids for treatment of renal malakoplakia.[sup][5] In the present case, although renal function was recovered after antibiotics treatment, repeated renal biopsy revealed significant infiltration of inflammatory cells in renal interstitium.
We recognize the rarity of the case, with less than 1000 patients diagnosed with malakoplakia per year in the U.S.
Murphy, "Nephrogenic adenoma of urinary bladder associated with malakoplakia," Urology, vol.
Although no characteristic Michaelis-Gutmann bodies were seen, the staining characteristics of the intracellular coccobacilli were compatible with Rhodococcus equi, a pathogen associated with malakoplakia. Combined treatment with ertapenem, teicoplanin, and amikacin was implemented but failed to induce clinical improvement.
Malakoplakia: Evidence for monocyte lysosomal abnormality correctable by cholinergic agonist in vitro and in vivo.
Michaelis-Gutmann bodies are present in malakoplakia, but not in XGC.
Ten (11.2%) cases of endocarditis were reported (8); there was also one case each of urinary tract malakoplakia after renal transplantation (9), lung abcess (10), diskitis (11), and lymphadenitis (12).
INTRODUCTION: Malakoplakia, an inflammatory condition first described by Michaelis and Gutmann in 1902.
Pulmonary malakoplakia is an uncommon manifestation of Rhodococcus equi infection seen almost exclusively in HIV-infected patients.