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Bladder Malakoplakia


Presentation

  • Here, we present a rare case, presenting as gall bladder mass in a known case of gallstone disease, clinically suspected as carcinoma and later turned out to be malakoplakia in gall bladder.[ijpmonline.org]
  • The computed tomographic (CT) findings of malakoplakia of the bladder are presented.[ncbi.nlm.nih.gov]
  • Journal of Computer Assisted Tomography: June 1983 CASE REPORT: PDF Only Abstract The computed tomographic (CT) findings of malakoplakia of the bladder are presented.[journals.lww.com]
Fever
  • She initially presented to an outside hospital with abdominal pain, nausea, emesis, fever and chills. She was diagnosed with and treated for pneumonia at the time.[austinpublishinggroup.com]
  • He had no fever or history of trauma. The measured values of hematological parameters and urine indexes were within the normal range. Urine culture did not reveal any growth.[e-sciencecentral.org]
  • A 29-year-old male presented with suprapubic pain, dysuria, increased frequency of micturition, and intermittent episodes of fever for 8 months. No diurnal variation of fever was noted. Hematuria was absent. Loss of weight and appetite were present.[urologyannals.com]
  • Given that our patient presented with a mild fever, leukocytosis, and tachycardia, it was highly suspected to be an infection. Clinical and histological chorioamnionitis was confirmed.[jpatholtm.org]
Pathologist
  • Edited by four leading surgical pathologists - Noel Weidner, MD, Richard J. Cote, MD, Saul Suster, MD and Lawrence M.[books.google.com]
  • Eighteen months prior to her visit to me she had passed in the urine a small piece of tissue which had been submitted to a pathologist, who had reported the tissue to be carcinoma.[jamanetwork.com]
  • Abstract Diagnosis of malakoplakia presenting as gall bladder mass is a diagnostic dilemma faced by pathologists, radiologists, and surgeons.[ijpmonline.org]
Inguinal Hernia
  • Since 1905 inguinal hernia, left sided rib fracture, and impairment of bladder function. Since this time felt weak and could not work. Last two years could no longer control his urine and it dribbled continually.[kundoc.com]
Hodgkin Lymphoma
  • Primary non-Hodgkin’s lymphoma and malakoplakia of the vagina: a case report. Hum Pathol. 1999;30:871-4.[cttr.org]
Aspiration
  • The atlas includes techniques of bronchoscopy, brochoalveolar lavage, and fine needle aspiration biopsy, a detailed section on cytopreparatory techniques, liberal use of images on histomorphology to complement cytology, emphasis on diagnostic pitfalls[books.google.com]
Vomiting
  • A 65 year-old nondiabetic male patient, known case of gallstone disease presented to the surgery outpatient department (OPD), Command Hospital, Udhampur, Jammu and Kashmir (India) with complaints of right-sided abdominal pain and vomiting.[ijpmonline.org]
  • Clinical manifestations of colonic malakoplakia are very diverse, from asymptomatic to the presence of diarrhea, abdominal pain, rectal bleeding, intestinal obstruction, vomiting, malaise, fever, and constipation [ 6 ].[ncbi.nlm.nih.gov]
Gastropathy
  • Gastritis Collagenous Gastritis Hypertrophic Gastropathies Hypoproteinemic Hypertrophic Gastropathy Zollinger-Ellison Syndrome Epithelial Polyps and Neoplasms of Stomach Hyperplastic Polyps Fundic Gland Polyps Pyloric Gland Adenoma Gastric Dysplasia[eneabrivio.com]
Osteoporosis
  • The patient had a past medical history of diabetes mellitus, hypertension, rheumatoid arthritis, and osteoporosis. She was taking insulin, teriparatide, low-dose prednisone, and valsartan.[urotoday.com]
Irritability
  • She came complaining of a severe irritation of the bladder. There was undue frequency of urination (nocturnal and diurnal), a burning sensation, and difficulty in voiding. This had been more or less continuous for about six years.[jamanetwork.com]
  • NUMBER 2 adenoma also probably is a benign metaplasia of the urothelium either due to chronic sepsis or irritation or trauma to the bladder .[kundoc.com]
  • , irritability R45.4 ICD-10-CM Diagnosis Code R45.4 Irritability and anger 2016 2017 2018 2019 Billable/Specific Code urethra N36.8 Leukoplakia urethra N36.8 (postinfectional) Malacoplakia urethra N36.8 Obstruction, obstructed, obstructive urethra NEC[icd10data.com]
  • Other clinical features include irritative voiding symptoms such as dysuria and pain, as well as urinary retention.[pubs.rsna.org]
Burning Sensation
  • There was undue frequency of urination (nocturnal and diurnal), a burning sensation, and difficulty in voiding. This had been more or less continuous for about six years.[jamanetwork.com]
Frequency of Micturition
  • Case Report A twelve-year-old black female was admitted to the urology service in 1972, with a history of gross, total, painless hematuria, and frequency of micturition .[kundoc.com]
  • A 29-year-old male presented with suprapubic pain, dysuria, increased frequency of micturition, and intermittent episodes of fever for 8 months. No diurnal variation of fever was noted. Hematuria was absent. Loss of weight and appetite were present.[urologyannals.com]
Urinary Urgency
  • Case Report A 62-year-old woman with hypertension, hyperlipidemia, poorly controlled diabetes and a history of stroke, first presented to her primary care physician with on and off hematuria, urinary urgency and frequency in November 2012.[casereports.in]
Pollakisuria
  • A case of malakoplakia of the urinary bladder in a 62-year-old woman with the chief complaints of pollakisuria was reported.[webview.isho.jp]

Workup

  • Respiratory cytopathology is indispensable in the workup of patients suspected of having lung cancer requiring cytologic evaluation and is used increasingly in immunocompromised patients for the identification of infectious diseases.[books.google.com]
  • 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.[e-sciencecentral.org]
  • JUL 2001; 22 (4) : 501-505 Vanzieleghem-BD; Lemmerling-MM; Vermeersch-HF; Govaert-P; Dhooge-I; Meire-F; Mortier-GR; Leroy-J; Kunnen-MF Imaging studies in the diagnostic workup of neonatal nasal obstruction JOURNAL-OF-COMPUTER-ASSISTED-TOMOGRAPHY.[malattierare.regione.veneto.it]
  • For the hematuria workup, no acid fast bacilli were found in the early morning urine samples, and there was no evidence of malignancy in the urine cytology specimens.[casereports.in]
Mycobacterium Avium Complex
  • Malakoplakia is morphologically very similar to Mycobacterium avium complex infection in AIDS patients and to Whipples disease and lepromatous leprosy.[pathpedia.com]

Treatment

  • Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances.[books.google.com]
  • This case report describes the first successful treatment of malakoplakia in veterinary medicine.[ncbi.nlm.nih.gov]
  • […] phagocytic or degradative functions of histiocytes in response to gram negative coliforms ( E. coli or Proteus ) that results in chronic inflammatory state, followed by intracellular deposition of iron and calcium (known as Michaelis-Gutmann bodies) Treatment[pathologyoutlines.com]
  • Indian J Pathol Microbiol 2017;60:122-4 The histopathological examination (HPE) of gall bladder sometimes reveal unique and interesting findings, thereby leading to change in entire treatment profile and thus making HPE must for all specimens.[ijpmonline.org]

Prognosis

  • […] mimicker from carcinoma gall bladder, possibility of coexistence of malakoplakia with malignancy and tuberculosis and to distinguish it from more common and less aggressive xanthogranulomatous cholecystitis, as this will change the treatment modalities, prognosis[ijpmonline.org]
  • The prognosis of patients with malakoplakia is usually good 4 . Follow-up, however, must be careful because long-term recurrence may occur 3 .[scielo.br]
  • Treatment and prognosis Although malacoplakia may be extremely aggressive, invading the perivesical space, and it can even cause bone destruction, non-surgical medical management is the mainstay of treatment, and as such, biopsy for accurate diagnosis[radiopaedia.org]
  • While most of the cases may be controlled by the above therapies, the prognosis may not be ideal in some immune suppressed patients [4].[austinpublishinggroup.com]
  • Ascorbic acid (vitamin C) Reduction of immunosuppressive medications Malakoplakia of the skin or tongue in isolation has an excellent prognosis. In some cases, there has been spontaneous resolution.[dermnetnz.org]

Etiology

  • One of the etiologies of malakoplakia is infection by Escherichia coli, which is supported by our data.[jstage.jst.go.jp]
  • […] and later named by Von Hansseman "Malakoplakia" comes from Greek words malakos (soft) and plakos (plaque) Epidemiology More common in immunocompromised (HIV, renal transplant recipients) and women Mean age at diagnosis is fifth decade Rare in children Etiology[pathologyoutlines.com]
  • Frequent association of bladder malakoplakia with urinary tract infection suggests an infectious etiologic agent.[e-sciencecentral.org]

Epidemiology

  • ) Single or multiple tumors Often misdiagnosed clinically as a malignant condition Terminology First described by Michaelis and Gutmann in 1902 and later named by Von Hansseman "Malakoplakia" comes from Greek words malakos (soft) and plakos (plaque) Epidemiology[pathologyoutlines.com]
  • AJNR-Am-J-Neuroradiol. 2000 Aug; 21(7): 1334-6 Martinez-Frias,-M-L; Bermejo,-E; Rodriguez-Pinilla,-E Anal atresia, vertebral, genital, and urinary tract anomalies: a primary polytopic developmental field defect identified through an epidemiological analysis[malattierare.regione.veneto.it]
  • […] mastectomy Concomitant urinary tract infection Prolonged therapy with systemic corticosteroids Other rare associations that have been reported include papillary urothelial carcinoma [11] and abdominal malakoplakia following blunt trauma to the abdomen. [12] Epidemiology[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of malakoplakiais thought to be associated with insufficient killing of bacteria by macrophages where the partially digested bacteria lead to a deposition of iron and calcium [6].[austinpublishinggroup.com]
  • Stevens , S. and McClure , J. ( 1982 ) The histochemical features of the Michaelis-Gutmann body and a consideration of the pathophysiological mechanisms of its formation . Journal of Pathology , 137 : 119 – 127 .[cambridge.org]
  • The pathophysiology of malakoplakia is unclear, but it is believed to be caused by inadequate bacterial phagocytosis due to lysosomal dysfunction.[urotoday.com]
  • Pathophysiology Malakoplakia is believed to result from the inadequate killing of bacteria by macrophages or monocytes that exhibit defective phagolysosomal activity.[emedicine.medscape.com]

Prevention

  • To learn more or modify/prevent the use of cookies, see our Cookie Policy and Privacy Policy . 70歳女.発熱を主訴とし,急性腎盂腎炎の診断がなされ,抗生物質の投与で経過観察されていたが腫瘤性病変に消退傾向が認められず悪性腫瘍が疑われ,精査加療目的のため当科入院した.診断の結果,悪性腫瘍を否定できず,脊椎麻酔下で経尿道的膀胱粘膜生検及び膀胱腫瘍切除術を施行した.病理所見では水腎症を呈した尿管・膀胱マラコプラキア[researchgate.net]
  • Early diagnosis together with adequate antibiotic treatment is important in patients with malakoplakia, and they should be closely followed up to prevent future development of renal insufficiency.[casereports.in]
  • These can be used long-term at low doses to prevent recurrence. Moreover, as immunosuppression has been implicated in malakoplakia, patients on immunosuppressants may need to discontinue them depending on the risk to benefit ratio.[ncbi.nlm.nih.gov]
  • Malakoplakia should always be considered as a differential diagnosis, in order to prevent misinterpretation of large nodules with fast growth, such as tumors, avoiding unnecessary and radical surgeries ( 4 , 8 ) .[scielo.br]

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