Cecal Malakoplakia - an Unusual Cause of Anemia in Liver Cirrhosis

Dina, Ion; Iacobescu, Claudia; Iordache, N; Gheorghița, Sergiu; Gurghean, Adriana

doi:10.15403/jgld-418

Cited by 1 publication

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“…Mass forming tumors mimicking malignancy have also been described [6][7][8]. Malakoplakia was initially described and most commonly found in the genitourinary tract but since its initial discovery in the early twentieth century, it has been reported in nearly every organ system, including the gastrointestinal [9][10][11][12][13][14][15], liver [16], central nervous system [17], renal [18], and pulmonary tract [19]. The gastrointestinal tract is the second most common organ system for malakoplakia involvement and it has been seen in association with colonic adenomas and adenocarcinomas [9,20,21].…”

Section: Introductionmentioning

confidence: 99%

Malakoplakia of the gastrointestinal tract: clinicopathologic analysis of 23 cases

Lee

Rubino

et al. 2020

Diagn Pathol

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Background: Malakoplakia is an uncommon, tumor-like inflammatory disease characterized by impaired histiocytes that are unable to completely digest phagocytized bacteria. The genitourinary tract is the most common site of involvement, however, cases have also been described in the gastrointestinal tract, suggesting that it is the second most common site of involvement. This study investigates the clinical and histologic features of malakoplakia in the gastrointestinal tract. Case presentation: For 23 gastrointestinal specimens (biopsies and resections) from patients with a pathologic diagnosis of malakoplakia, we recorded the gender, age, location, primary diagnosis, endoscopic or surgical indication, endoscopic/gross impression and immune status (immunocompromised vs. immunocompetent). Conclusion: Malakoplakia occurred throughout the length of the gastrointestinal tract with most of the cases located in the sigmoid colon and rectum (n = 10); other sites included the transverse and descending colon (n = 4), stomach/gastroesophageal junction (n = 4), appendix (n = 2), cecum (n = 1), small bowel (n = 1), and the peri-anal area (n = 1). Endoscopically, these lesions most commonly appeared as polyps (n = 10) or masses (n = 5), other clinical endoscopic impressions varied from a thickened area/fibrosis to mucosal erythema. Most patients were immunocompromised due to a disease state (e.g. organ transplantation, cancer diagnosis, autoimmune condition) and/or medication effect. Eight patients with malakoplakia were on immunosuppressive medications (8/23, 35%). Common immunosuppressed disease states included cancer (n = 9), autoimmune disease (n = 5), status post organ transplantation (n = 4), diabetes (n = 5), infection/sepsis (n = 3), and HIV/AIDS (n = 1). Some patients had multiple comorbidities (i.e. diabetes and organ transplant). Twenty-one patients with malakoplakia were in an immunosuppressive state (21/23, 91%).

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