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• W2977353377 abstract "Introduction: Malakoplakia is a rare, chronic granulomatous disease that is thought to occur as an acquired phagocytic deficiency in macrophages leading to an inability to fully digest bacteria first described in 1902.1-3 The majority of cases involve the genitourinary tract, however 11% of cases occur in the GI tract.3-5 Malakoplakia is rare in healthy people and is typically associated with chronic illness or immunosuppression.6 Case Report: Our asymptomatic 62 year old female patient was referred to our practice for average risk colon cancer screening. She was not taking medications. She denied abdominal pain, altered bowel habits, weight loss, or blood in her stool. Screening colonoscopy was performed and was notable for four pink-tan sessile polyps measuring 1 mm in the rectum. Cold forceps polypectomy was performed and cytohistochemistry was consistent with a diagnosis of malakoplakia. The patient confirmed no history of illness including autoimmune disease or chronic inflammatory conditions. Chemistry panel, CBC, hepatitis serologies, HIV, Immunoglobulin E, G, and M were all within normal limits. CT scan of chest, abdomen and pelvis showed no abnormalities. Endoscopic ultrasound of the rectum was normal. As patient was asymptomatic she received no further treatment. Discussion: Diagnosis of malakoplakia remains difficult given the variable clinical and endoscopic presentation.7 The endoscopic appearance of malakoplakia is heterogeneous.8-11 Accurate diagnosis requires histopathologic findings of histiocyte aggregates with eosinophilic cytoplasm, known as von Hansemann cells and the pathognomonic Michaelis-Gutmann bodies which are mineralized intracytoplasmic partially digested microorganisms within the lysosome that stain positive with periodic acid-Schiff, Von Kossa, and Prussian blue for their high glycogen, calcium, and iron content.6,12-17 The pathogenesis of malakoplakia is thought to involve infection followed by an inadequate host and inflammatory response.3,18-20 Previous studies have implicated bacteria as the source of infection with Escherichia coli being found in over 90% of cases21 but viruses, including HPV, have also been described.11 Roughly 40% of patients with malakoplakia have a primary or acquired immunodeficiency.22 Treatment includes cessation of immunosuppressive therapy, surgery, cholinergic agonists, or antibiotics.6,23-28 In asymptomatic cases such as ours, no treatment may be necessary." @default.
• W2977353377 created "2019-10-10" @default.
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• W2977353377 date "2015-10-01" @default.
• W2977353377 modified "2023-09-27" @default.
• W2977353377 title "Rectal Malakoplakia in a Healthy, Asymptomatic Female" @default.
• W2977353377 doi "https://doi.org/10.14309/00000434-201510001-00417" @default.
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