Michaelis-Gutmann bodies in a healing brain infarct.

Abstract

A case of Michaelis-Gutmann bodies in a healing brain infarct is described. Morphologically this was consistent with cerebral malacoplakia. There are only 6 previously reported cases of cerebral malacoplakia, and only 1 of them was a consequence of postpartum stroke. The histologic and ultrastructural features of the malacoplakic lesion are reported and compared with the previously reported cases. (Stroke 1987;18:947-950) T he accumulation of histiocytes containing Michaelis-Gutmann (MG) bodies is rare. MG bodies are calcified, laminated, periodic acidSchiff (PAS)-positive inclusions that were first described by Michaelis and Gutmann in 1902.' Malacoplakia usually involves the urinary bladder, but involvement of other sites has been reported. 2 "* Cerebral malacoplakia seems to be very rare. In a search of the literature we located only 6 previously reported cases of cerebral malacoplakia. Most were in children in association with neonatal herpes infection, 5 " 8 and 1 case was in a young woman who died as a consequence of postpartum stroke. 9 We report the histochemical and ultrastructural findings of MG bodies in a healing brain infarct. To the best of our knowledge, our 72-year-old patient is the oldest case of cerebral malacoplakia reported in the literature. Report of a CaseA 72-year-old man was admitted to the hospital because of sudden onset of confusion and dysarthria. Past medical history included congestive heart failure and chronic atrial fibrillation. Physical examination on admission revealed a right central facial palsy.Laboratory findings were 80 mg% urea, 1.5 mg% creatinine, 10 mg% calcium, and 4.1 mg% phosphate; electrocardiogram showed atrial fibrillation. Chest xray examination displayed enlargement of the heart, mild pulmonary congestion, and a small pleural effusion. The electroencephalogram revealed slow wave activity in the left temporal region. The diagnosis of a thromboembolic event in the form of a cerebrovascular "accident" was made.On the seventh day of hospitalization the patient began complaining of abdominal pain. Serum urea rose to 110 and creatinine to 2.4 mg%, while calcium

Focal malakoplakia in chronic periapical periodontitis

“…25 Finally, instances of focal malakoplakia in cerebral infarctions have been reported. [11][12][13] Our observations and these anecdotal cases support the opinion that the local conditions for the production of MG bodies may occur focally in diverse lesions characterized by macrophage accumulation. These focal changes could be related to differences in the local bacterial antigen load.…”

“…Malakoplakia is mainly found in the genitourinary tract. The cases reported from the head and neck region 3 affected the eyelid, middle ear, thyroid gland, brain, [11][12][13] parotid gland, tongue, 14 maxillary sinus, 15 submental region, and oropharyngeal soft tissues. Outside the bladder, malakoplakia often develops in patients with carcinoma 16 or with impaired function of the mononuclear phagocytic system.…”

A case of lymphocytic panhypophysitis (LPH) during pregnancy

“…Epidemiologically, the incidence of LH is significantly higher during pregnancy because of unknown causes [10,17], and it was associated with sudden maternal death because of hypopituitarism until recently [18,19]. Prompt diagnosis and treatment are necessary for the fetomaternal safety.…”