Diagnosis of Renal Malacoplakia by Fine Needle Aspiration Cytology

Kapasi, Hassanali; Robertson, Susan J.; Futter, Norman G.

doi:10.1159/000332178

Cited by 24 publications

(17 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Fine needle aspiration helped as a preliminary diagnostic method and showed large foamy macrophages with Michaelis-Gutmann bodies, so the renal malakoplakia was diagnosed before surgery. This patient also showed malakoplakia as a cystic mass in contrast with our patient, who had a solid mass [12]. There are two reported cases of renal malakoplakia leading to renal failure.…”

Section: Discussionsupporting

confidence: 39%

See 1 more Smart Citation

Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report

et al. 2012

View full text Add to dashboard Cite

IntroductionMalakoplakia is an uncommon chronic inflammatory condition that has a gross and microscopic appearance resembling that of xanthogranulomatous pyelonephritis. It is characterized by distinctive Michaelis-Gutmann bodies. Malakoplakia can affect any organ system but genitourinary tract involvement is the most common, particularly in immunocompromised individuals. Very rare cases have been reported to present as a unifocal lesion mimicking a renal tumor.Case presentationWe report a case of renal malakoplakia in a 55-year-old Iranian man with a past history of recurrent urinary tract infections who presented with left flank pain. An ultrasound study showed a large solid left renal mass, and he underwent a left radical nephrectomy with a clinical diagnosis of a renal tumor. Pathology slides revealed the diffuse infiltration of sheets of Periodic Acid Schiff-positive histiocytes in his renal parenchyma; these cells showed strong immunoreactivity for CD 68. The final diagnosis was renal malakoplakia.ConclusionRenal malakoplakia must be kept in mind for patients presenting with a renal mass and a history of long-term recurrent renal infections or renal failure. The large, rapidly growing nodules of malakoplakia may mimic renal cell carcinoma in imaging studies. In these cases, a true cut needle biopsy may help the correct diagnosis and prevent unnecessary surgery.

show abstract

Section: Discussionsupporting

confidence: 39%

“…[12], a 67-year-old man presented with acute left loin pain. Imaging studies showed a cystic mass with a thickened, irregular wall within his left renal sinus.…”

Section: Discussionmentioning

confidence: 99%

Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report

et al. 2012

View full text Add to dashboard Cite

show abstract

“…A patient has been reported who had a complicated, unifocal cystic renal mass diagnosed as malacoplakia on the basis of a fine-needle aspirate in whom the lesion resolved after a 1-month course of antibiotic therapy [8].…”

Section: Wielenberg Et Almentioning

confidence: 99%

Malacoplakia Presenting as a Solitary Renal Mass

Wielenberg

Demos

Rangachari

et al. 2004

American Journal of Roentgenology

View full text Add to dashboard Cite

1703alacoplakia, a rare granulomatous inflammatory disease characterized by pathognomonic intracytoplasmic Michaelis-Gutmann bodies, was first reported as a lesion of the urinary bladder in 1902. Until the 1950s, this disease was thought to occur exclusively in the urinary tract. Malacoplakia, however, affects many other organ systems including the gastrointestinal tract, bone, lungs, lymph nodes, and skin. The urinary tract is most frequently involved, and all parts of the urinary tract can be affected. In a 1981 review of 153 cases, 89 (58%) had involvement of the urinary tract and 63 (40%) had bladder lesions. The next most common site was the kidney (16%) [1]. Sixty-two cases of renal involvement were found in a review published in 1993 [2]. Renal lesions are most often multifocal and frequently involve both kidneys. We report a case of malacoplakia in a 37-year-old man who presented with a complicated cystic renal lesion that increased in size over the 2 years that he was monitored using CT. Case ReportA 37-year-old man with no significant medical history was referred for evaluation of an enlarging cystic renal mass that had been followed for 2 years using CT. The patient initially presented for treatment of acute bacterial prostatitis, which subsequently resolved with antibiotic therapy. An initial CT study of the abdomen, performed for evaluation of persistent microscopic hematuria after this episode, showed a 2-cm, predominantly low-attenuation lesion with a septum located in the upper pole of the left kidney (Figs. 1A and 1B). On CT 2 years later, the lesion had increased in size and measured 2.8 cm in diameter. The lesion was heterogeneous with an attenuation of 27 H (Figs. 1C and 1D). Because unenhanced images were not obtained for either study, enhancement could not be determined. Because this lesion not only was a complicated cystic lesion but had enlarged in the interval, the patient underwent laparoscopic radical nephrectomy, which was performed without complication. Subsequent CT and sonography of the abdomen and urine cultures have remained normal at 1-year follow-up.On gross examination, the lesion was multiloculated; measured 2.5 × 1.2 × 1.2 cm; had a smooth, thickened inner lining; and contained grossly hemorrhagic fluid. Microscopic examination of the renal parenchyma and calices showed well-delineated aggregates of histiocytes with intracellular round, concentric, laminar, Michaelis-Gutmann bodies positive for anions of calcium salts using von Kossa's stain. No microorganisms were present. DiscussionMalacoplakia is a rare granulomatous inflammatory process that affects many organ systems including the genitourinary tract, gastrointestinal tract, bone, lungs, lymph nodes, and skin. Aside from the urinary tract, no sex predominance is seen. The genitourinary tract is affected most often, particularly in immunocompromised individuals. Disease of the genitourinary system is most common in middle-aged women (female-male ratio, 4:1), with an average age at presentation of more than 50 years [1]. M...

show abstract

“…2,3 On CT, the most common findings are nephromegaly and parenchymal inhomogeneity. 5,12 Previously, nephrectomy was the only treatment for malacoplakia; in most cases, the nephrectomy was done based on a preoperative diagnosis of a renal neoplasm. 5 Sonographically guided biopsies and fine-needle aspirations have been performed in most of the reported cases, as in our case.…”

Section: Discussionmentioning

confidence: 99%

“…The etiology of the disorder is not known, although an immunologic defect has been proposed as a cause. [2][3][4][5][9][10][11][12][13][14] We re-port a case of bilateral renal malacoplakia in which the kidney lesion on 1 side was managed conservatively and monitored using sonography. Nephrectomy was performed in most cases in the past 2 ; medical management has been successful in more recent cases.…”

mentioning

confidence: 99%

Sonographic findings in renal parenchymal malacoplakia

Venkatesh

Mehrotra

Gujral

2000

J. Clin. Ultrasound

View full text Add to dashboard Cite

Malacoplakia of the kidney is a rare inflammatory disorder. We describe a case of bilateral renal malacoplakia in which the patient had diffuse involvement of the left kidney and a focal lesion in the right kidney. Sonography showed a diffusely echogenic, enlarged left kidney with loss of corticomedullary differentiation and a single anechoic lesion measuring 1.8 × 1.6 × 1.3 cm in the right kidney. A left nephrectomy was performed, and the right kidney was managed conservatively with sonographic monitoring. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:353–357, 2000.

show abstract

Diagnosis of Renal Malacoplakia by Fine Needle Aspiration Cytology

Cited by 24 publications

References 10 publications

Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report

Renal malakoplakia presenting as a renal mass in a 55-year-old man: a case report

Malacoplakia Presenting as a Solitary Renal Mass

Sonographic findings in renal parenchymal malacoplakia

Contact Info

Product

Resources

About