Sonographic findings in renal parenchymal malacoplakia

Abstract

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.

Multimodal imaging appearance including cinematic rendering of renal malakoplakia in a patient with E. coli bacteremia

“…Previous literature has described the imaging findings of renal malakoplakia using imaging modalities including ultrasound, CT, and MRI. In prior literature, findings such as diffusely increased renal parenchymal echogenicity, loss of corticomedullary differentiation, nephromegaly, and renal masses on ultrasound have been associated with renal malakoplakia [9 , 10] . In terms of CT findings, nephromegaly, mass-like lesions, abscesses, and inflammatory changes have been seen in renal malakoplakia patients [1 , 5 , 6 , 8] .…”

“…Fluoroquinolones are especially effective at treating malakoplakia, perhaps due to achieving high intracellular concentrations achieved in macrophages [12] . Bethanechol and ascorbic acid have also been used as adjuvant therapy due to their ability to increase the intracellular cGMP:cAMP ratio and increase bacteriocidal activity of monocytes and macrophages [10 – 12] . These treatments generally have favorable outcomes [12] .…”