Humans ; Malacoplakia/diagnosis* ; Palatine Tonsil

Malacoplakia is an uncommon granulomatous inflammatory disease, which predomina- ntly affected the urinary tract, particularly the urinary bladder. The prostatic involve- ment of malacoplakia is extremely rare and may clinically mimic prostate cancer. A correct diagnosis of malacoplakia can be made by histopathologic findings characterized by accumulations of macrophages containing typical intracytoplasmic inclusions(Michael is-Gutmann bodies). We report a case of prostatic malacoplakia, which was incidentally found in prostate biopsy performed to confirm clinically suspected prostate cancer.
Biopsy ; Diagnosis ; Macrophages ; Malacoplakia* ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Tract

Malakoplakia is usually found in the genitourinary tract; however, it occurs uncommonly as a chronic inflammatory disease and rarely in the head and neck area, having been reported in the literature only few times. Here, we report, with a review of the related literature, a case of malakoplakia on the posterior neck. A 76-year-old male patient visited our institution presenting a rapidly growing neck mass that had invaded the overlying skin for several weeks. The results of imaging studies strongly indicated a malignant tumor, but an accurate diagnosis was not made until after a fine needle aspiration biopsy was undertaken twice. The lesion was completely excised with an extended radical neck dissection including the overlying skin and scalene muscle upon consent of the patient. The pathological diagnosis was made with various immunohistochemical staining methods including Von Kossa, Periodic acid-Schiff-diastase, CD-68 and CD163. During the 24 months follow-up after the surgery, there was no sign of recurrence.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Follow-Up Studies ; Head ; Humans ; Lymphatic Diseases ; Malacoplakia ; Male ; Neck Dissection ; Neck ; Recurrence ; Skin

Liesegang rings (LRs) are peculiar structure of periodic precipitation zones from supersaturated solution in colloidal system. LRs are formed by a process referred to as "the Liesegang phenomenon". Here we describe LRs in renal hemorrhagic cyst from the donor kidney of a 59-year-old man. His general condition was good. Abdominal ultrasonography revealed a simple cyst in the left kidney. After donor nephrectomy for renal transplantation, a 3x2 cm sized cyst containing the brownish necrotic fluid was noted in the upper pole of left kidney. Frozen section from the relatively thickened cystic wall was performed. During frozen section examination, round concentric rings with double-layered outer wall, striations and amorphous central nidus admixed with the foamy macrophages were found and the lesion was originally interpreted as xanthogranulomatous inflammation with unusual crystalline structures in the cytoplasm of macrophages or freely in the interstitium. Macrophages with calcium crystals or malakoplakia were also considered at that time. Additional specimen for the permanent sections showed a simple hemorrhagic renal cyst with areas of small or large aggregates of LRs along the cyst wall. Multiple round ring-like structures ranging from 11 to 42 micrometer in diameter had uniform, pale eosinophilic, radially striated double wall. Histochemical and immunohistochemical stainings for iron, calcium, mucopolysaccharide, amyloid, cytokeratin were negative in these structures. They were highlighted by CD68 immunostaining as well as PAS and Masson's trichrome stainings. Awareness of Liesegang phenomenon in cystic lesions will decrease the possibility of erroneous diagnosis as another type of pathologic process, such as parasitic worms or eggs.
Amyloid ; Calcium ; Colloids ; Crystallins ; Cytoplasm ; Diagnosis ; Eggs ; Eosinophils ; Frozen Sections ; Helminths ; Humans ; Inflammation ; Iron ; Keratins ; Kidney Transplantation ; Kidney* ; Macrophages ; Malacoplakia ; Middle Aged ; Nephrectomy ; Ovum ; Tissue Donors* ; Ultrasonography

Renal malakoplakia (RM) with secondary hepatic involvement is extremely rare. There are only two cases reported in literature. We report the first case of RM with secondary hepatic extension in Korea. A 70-year-old woman had a history of long-term oral steroids intake. A radical nephrectomy and a segmental hepatectomy were performed under the clinical impression of a renal cell carcinoma with hepatic extension on the dynamic liver computed tomography. The gross specimen revealed a lobulated yellowish-tan, soft mass (9 X 8 X 5 cm) with hepatic involvement in the upper pole of the right kidney. The hematoxylin and eosin, Prucian blue and von-Kossa stainings, and electron microscopy demonstrated the classical histologic features of malakoplakia with Von Hansemann histiocytes containing Michaelis-Gutmann bodies. The patient is well 5 months after surgery. This case emphasizes that initial diagnoses can be difficult because of the rare occurrence of RM and its resemblance to renal cell carcinoma with hepatic extension.
Aged ; Carcinoma, Renal Cell ; Diagnosis ; Eosine Yellowish-(YS) ; Female ; Hematoxylin ; Hepatectomy ; Histiocytes ; Humans ; Kidney ; Korea ; Liver ; Malacoplakia* ; Microscopy, Electron ; Nephrectomy ; Steroids

Malacoplakia is a rare, chronic inflammatory disorder characterized by abnormal macrophage function and cell infiltration into normal tissues. We report a 72 year old male with bilateral renal parenchymal malacoplakia who presented with high fever and acute renal failure. The patient had anemia, leukocytosis, thrombocytopenia and bilateral nephromegaly with reduced renal function. Blood and urine cultures showed no micro-organisms. A kidney biopsy revealed diffuse interstitial histiocytic infiltration with intracellular inclusion bodies(Michaelis-Gutmann body). He was treated with antibiotics, and bethanechol, ascorbic acid without improvement. Following treatment with an intravenous methylprednisolone pulse therapy, clinical improvement was made. Renal parenchymal malacoplakia should be considered in the differential diagnosis when presented with high fever, enlarged kidneys and acute renal failure.
Acute Kidney Injury* ; Aged ; Anemia ; Anti-Bacterial Agents ; Ascorbic Acid ; Bethanechol ; Biopsy ; Diagnosis, Differential ; Fever* ; Humans ; Kidney ; Leukocytosis ; Macrophages ; Malacoplakia* ; Male ; Methylprednisolone ; Thrombocytopenia

Malacoplakia is a rare, chronic inflammatory disorder characterized by abnormal macrophage function and cell infiltration into normal tissues. We report a 72 year old male with bilateral renal parenchymal malacoplakia who presented with high fever and acute renal failure. The patient had anemia, leukocytosis, thrombocytopenia and bilateral nephromegaly with reduced renal function. Blood and urine cultures showed no micro-organisms. A kidney biopsy revealed diffuse interstitial histiocytic infiltration with intracellular inclusion bodies(Michaelis-Gutmann body). He was treated with antibiotics, and bethanechol, ascorbic acid without improvement. Following treatment with an intravenous methylprednisolone pulse therapy, clinical improvement was made. Renal parenchymal malacoplakia should be considered in the differential diagnosis when presented with high fever, enlarged kidneys and acute renal failure.
Acute Kidney Injury* ; Aged ; Anemia ; Anti-Bacterial Agents ; Ascorbic Acid ; Bethanechol ; Biopsy ; Diagnosis, Differential ; Fever* ; Humans ; Kidney ; Leukocytosis ; Macrophages ; Malacoplakia* ; Male ; Methylprednisolone ; Thrombocytopenia

Acute Kidney Injury ; diagnosis ; drug therapy ; etiology ; Adult ; Anti-Bacterial Agents ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Female ; Humans ; Kidney Diseases ; diagnosis ; drug therapy ; Levofloxacin ; therapeutic use ; Malacoplakia ; complications ; diagnosis ; drug therapy ; Prednisone ; therapeutic use

Malakoplakia is a chronic inflammatory disorder that usually affects the urinary tract in immunocompromised patients and rarely extends to adjacent organs. Due to its mass-like presentation, malakoplakia is often clinically misdiagnosed as a neoplastic lesion. We describe the case of a 51-year-old female with renal malakoplakia and hepatic extension and large intraperitoneal abscesses that had been misdiagnosed as malignancy. She was diagnosed with myasthenia gravis 12 years prior and had been treated with oral corticosteroids and immunosuppressants. Radical nephrectomy concomitant with abscess drainage was performed. The final pathology was compatible with malakoplakia, and the patient was successfully treated with antibiotics. Although renal malakoplakia is a rare disease, it should be included in the differential diagnosis of patients with a renal mass who have a history of recurrent urinary tract infections or evidence of immunosuppression.
Abscess ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Diagnosis, Differential ; Drainage ; Female ; Humans ; Immunocompromised Host ; Immunosuppression ; Immunosuppressive Agents ; Kidney ; Liver ; Malacoplakia ; Middle Aged ; Myasthenia Gravis ; Nephrectomy ; Rare Diseases ; Urinary Tract ; Urinary Tract Infections

Malakoplakia is a chronic inflammatory disorder that usually affects the urinary tract in immunocompromised patients and rarely extends to adjacent organs. Due to its mass-like presentation, malakoplakia is often clinically misdiagnosed as a neoplastic lesion. We describe the case of a 51-year-old female with renal malakoplakia and hepatic extension and large intraperitoneal abscesses that had been misdiagnosed as malignancy. She was diagnosed with myasthenia gravis 12 years prior and had been treated with oral corticosteroids and immunosuppressants. Radical nephrectomy concomitant with abscess drainage was performed. The final pathology was compatible with malakoplakia, and the patient was successfully treated with antibiotics. Although renal malakoplakia is a rare disease, it should be included in the differential diagnosis of patients with a renal mass who have a history of recurrent urinary tract infections or evidence of immunosuppression.
Abscess ; Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Diagnosis, Differential ; Drainage ; Female ; Humans ; Immunocompromised Host ; Immunosuppression ; Immunosuppressive Agents ; Kidney ; Liver ; Malacoplakia ; Middle Aged ; Myasthenia Gravis ; Nephrectomy ; Rare Diseases ; Urinary Tract ; Urinary Tract Infections