Korean J Pathol.  2013 Apr;47(2):163-166.

Silent Colonic Malakoplakia in a Living-Donor Kidney Transplant Recipient Diagnosed during Annual Medical Examination

• Bae GE
• Yoon N
• Park HY
• Ha SY
• Cho J
• Lee Y
• Kim KM
• Park CK

Abstract

Malakoplakia is a characteristic inflammatory condition, which is usually seen in the urogenital tract, and less frequently in the gastrointestinal tract. We present a case of colonic malakoplakia in an immunocompromised patient. A 55-year-old female visited the outpatient clinic for routine cancer surveillance. Her past medical history was significant for kidney transplantation 11 years ago, and she had been taking immunosuppressants. A colonoscopy revealed several depressed flat lesions and elevated polyps, which were 0.3 to 0.4 cm in size and accompanied by whitish exudates. A biopsy revealed an infiltration of histiocytes with ample granular eosinophilic cytoplasm, with some lymphocytes and plasma cells. Many histiocytes had the characteristic morphology, described as Michaelis-Gutmann bodies: one or several round basophilic structures of approximately 1 to 10 microm in size with some being laminated, some appearing homogeneous, and others having a dense central core with a targetoid appearance. These Michaelis-Gutmann bodies were positively stained on von Kossa stain, and were diagnostic for malakoplakia.

Keyword

Malakoplakia; Colon; Kidney transplantation

MeSH Terms

Ambulatory Care Facilities
Basophils
Biopsy
Colon
Colonoscopy
Cytoplasm
Eosinophils
Exudates and Transudates
Female
Gastrointestinal Tract
Histiocytes
Humans
Immunocompromised Host
Immunosuppressive Agents
Kidney
Kidney Transplantation
Lymphocytes
Malacoplakia
Plasma Cells
Polyps
Transplants
Immunosuppressive Agents