Malakoplakie des Kolons

Abstract

We report on a 62-year-old female patient with melena in which polypoid lesions of the cecum were discovered endoscopically. Histological examination of mucosal biopsies revealed an inflammatory process with lots of histiocytes and so-called Michaelis-Gutmann bodies, leading to the diagnosis of a malakoplakia of the colon. No other organs were found affected. In the course of an antibiotic therapy, there was no melena detectable over a period of six months. Malakoplakia, an inflammation usually affecting the urogenital tract, is rarely found in the colon, with only 35 cases published until now. It is frequently associated with other diseases like neoplastic or inflammatory disorders, immune defect syndromes or heroin abuse. This spectrum is expanded by our report in which a long-standing alcohol abuse was found as an attendant disease.

The comparative importance of E. coli antigen in granulomatous colitis of Boxer dogs

“…Malacoplakia has been reproduced experimentally when endotoxin‐antigen complex of E. coli 075 was injected into kidney and testis (30). In malacoplakia, mineralized phagolysosomes, Michaelis‐Gutmann bodies, occur as well, among the other macrophage contents (17–21, 28, 29). These are not seen in the Boxer colitis.…”

“…For the most part, the disease is localized to the large intestine and regional lymph nodes; however, in some instances the macrophages, which are PAS‐positive, occur in lymph nodes remote from the intestine, suggesting that there is limited systemic distribution of the etiologic agent. In addition to Whipple's disease in humans (5–10), which is caused by Tropheryma whippelii , the Boxer colitis has morphologic similarity to Johne's disease of ruminants (11–13), caused by Mycobacterium paratuberculosis , Mycobacterium avium enteritis (14, 15), Rhodococcus equi enteritis of foals (16) and intestinal malacoplakia (17–21). In these diffuse, or lepromatous, granulomatous diseases, the macrophages that characterize the lesion sometimes contain demonstrable organisms, seen when special stains or electron microscopy are applied.…”