BACKGROUND Malakoplakia is a rare chronic granulomatous disease associated with gramnegative infection,predominantly by Escherichia coli.It is induced by defective phagolysosomal activity of the macrophages.Malakoplak...BACKGROUND Malakoplakia is a rare chronic granulomatous disease associated with gramnegative infection,predominantly by Escherichia coli.It is induced by defective phagolysosomal activity of the macrophages.Malakoplakia commonly affects the urinary bladder but has been shown to affect any solid organ,including the native and transplanted kidney.However,isolated malakoplakia of the kidney allograft is rare.Transplant recipients with compromised immune systems are more likely to develop malakoplakia.CASE SUMMARY We report three cases of kidney allograft parenchymal malakoplakia in kidney transplant recipients on immunosuppression that were successfully managed with good outcomes.We described the clinical characteristics of all the kidney allograft malakoplakia cases documented in the literature.A total of 55 cases of malakoplakia were reported in recipients with a history of kidney transplant.A total of 27 recipients had malakoplakia involving the allograft,and others had malakoplakia in other organs.The common presentations included allograft dysfunction,pyelonephritis,and allograft or systemic mass.Most recipients had favorable outcomes with appropriate management that included prolonged antibiotic therapy and adjustment of immunosuppression.We reviewed the published literature on all the cases of malakoplakia in kidney transplant recipients so far and summarized the etiology,management,and outcomes.CONCLUSION This case series provides an overview of the etiology,presentation,pathogenesis,and management of malakoplakia in kidney transplant recipients.展开更多
Malakoplakia is an uncommon chronic inflammatory disease usually affecting the urogenital tract and often associated with the infection due to?E. coli. It is characterised by the presence of Von Hansemann cells and in...Malakoplakia is an uncommon chronic inflammatory disease usually affecting the urogenital tract and often associated with the infection due to?E. coli. It is characterised by the presence of Von Hansemann cells and intracytoplasmic inclusion bodies called Michaelis-Gutmann Bodies. Testes are affected in 12% cases. The lesion mainly occurs in middle aged men, appearing clinically as epididymo-orchitis or testicular enlargement with fibrous consistency and some soft areas. Orchidectomy is the only way to differentiate the lesion from other malignant or infected processes. This is a case report of a young patient with testicular malakoplakia.展开更多
Introduction: Malakoplakia is a rare acquired granulomatous inflammatory condition. Microscopically it is characterized by sheets of histiocytes with abundant eosinophilic granular cytoplasm (known as von Hansemann ce...Introduction: Malakoplakia is a rare acquired granulomatous inflammatory condition. Microscopically it is characterized by sheets of histiocytes with abundant eosinophilic granular cytoplasm (known as von Hansemann cells) with intracytoplasmic rounded concentric basophilic inclusions (Michelis-Guttmann bodies). We reviewed all cases of malakoplakia diagnosed at our institution in the past 15 years, including clinical, macroscopic, and microscopic features as well as treatment and prognosis. Methods: Gross and microscopic features of cases diagnosed as malakoplakia from 2005 to 2019 at our institution were reviewed. Clinical history, including sites of involvement, clinical presentation, imaging, past medical history, treatment, follow-up and prognosis, as well as demographic characteristics were obtained. Results: Eighteen surgical pathology cases of malakoplakia were identified. Most cases occurred in female (14/18, 77.8%) and all in adults (median age 48.5 years;range 31 - 87). Half of the patients were Caucasian, 44% African American and 6% were reported as “other” race. One third (6/18) of patients presented with a mass-like lesion on imaging or endoscopic studies. As to site of lesion, 61.1% (11/18) involved GU tract, 27.8% (5/18) gastrointestinal (GI) tract, 5.6% (1/18) liver, and 5.6% (1/18) vagina. 38.9% of patients (7/18) had antibiotics treatment upon diagnosis. Conclusion: Malakoplakia is a rare disorder occurring in a wide age range, more commonly in females, with no significant racial prevalence. While the GU and GI tracts are the most common sites, other anatomic locations can be involved. Accurate diagnosis and appropriate treatment are important to avoid recurrence.展开更多
文摘BACKGROUND Malakoplakia is a rare chronic granulomatous disease associated with gramnegative infection,predominantly by Escherichia coli.It is induced by defective phagolysosomal activity of the macrophages.Malakoplakia commonly affects the urinary bladder but has been shown to affect any solid organ,including the native and transplanted kidney.However,isolated malakoplakia of the kidney allograft is rare.Transplant recipients with compromised immune systems are more likely to develop malakoplakia.CASE SUMMARY We report three cases of kidney allograft parenchymal malakoplakia in kidney transplant recipients on immunosuppression that were successfully managed with good outcomes.We described the clinical characteristics of all the kidney allograft malakoplakia cases documented in the literature.A total of 55 cases of malakoplakia were reported in recipients with a history of kidney transplant.A total of 27 recipients had malakoplakia involving the allograft,and others had malakoplakia in other organs.The common presentations included allograft dysfunction,pyelonephritis,and allograft or systemic mass.Most recipients had favorable outcomes with appropriate management that included prolonged antibiotic therapy and adjustment of immunosuppression.We reviewed the published literature on all the cases of malakoplakia in kidney transplant recipients so far and summarized the etiology,management,and outcomes.CONCLUSION This case series provides an overview of the etiology,presentation,pathogenesis,and management of malakoplakia in kidney transplant recipients.
文摘Malakoplakia is an uncommon chronic inflammatory disease usually affecting the urogenital tract and often associated with the infection due to?E. coli. It is characterised by the presence of Von Hansemann cells and intracytoplasmic inclusion bodies called Michaelis-Gutmann Bodies. Testes are affected in 12% cases. The lesion mainly occurs in middle aged men, appearing clinically as epididymo-orchitis or testicular enlargement with fibrous consistency and some soft areas. Orchidectomy is the only way to differentiate the lesion from other malignant or infected processes. This is a case report of a young patient with testicular malakoplakia.
文摘Introduction: Malakoplakia is a rare acquired granulomatous inflammatory condition. Microscopically it is characterized by sheets of histiocytes with abundant eosinophilic granular cytoplasm (known as von Hansemann cells) with intracytoplasmic rounded concentric basophilic inclusions (Michelis-Guttmann bodies). We reviewed all cases of malakoplakia diagnosed at our institution in the past 15 years, including clinical, macroscopic, and microscopic features as well as treatment and prognosis. Methods: Gross and microscopic features of cases diagnosed as malakoplakia from 2005 to 2019 at our institution were reviewed. Clinical history, including sites of involvement, clinical presentation, imaging, past medical history, treatment, follow-up and prognosis, as well as demographic characteristics were obtained. Results: Eighteen surgical pathology cases of malakoplakia were identified. Most cases occurred in female (14/18, 77.8%) and all in adults (median age 48.5 years;range 31 - 87). Half of the patients were Caucasian, 44% African American and 6% were reported as “other” race. One third (6/18) of patients presented with a mass-like lesion on imaging or endoscopic studies. As to site of lesion, 61.1% (11/18) involved GU tract, 27.8% (5/18) gastrointestinal (GI) tract, 5.6% (1/18) liver, and 5.6% (1/18) vagina. 38.9% of patients (7/18) had antibiotics treatment upon diagnosis. Conclusion: Malakoplakia is a rare disorder occurring in a wide age range, more commonly in females, with no significant racial prevalence. While the GU and GI tracts are the most common sites, other anatomic locations can be involved. Accurate diagnosis and appropriate treatment are important to avoid recurrence.
