Difference between revisions of "Malakoplakia"

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'''Malakoplakia''' is a thingy that typically arises in the bladder.
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Michaelis-Gutmann_bodies_-_very_high_mag_-_cropped.jpg
| Width      =
| Caption    = Malakoplakia with numerous Michaelis-Gutmann bodies. [[H&E stain]].
| Micro      = basophilic calcified bodies approximately the size of a RBC (Michaelis-Gutmann body) - inside or outside of macrophages, large foamy macrophages with granular cytoplasm +/- multinucleation, lymphocytes
| Subtypes  =
| LMDDx      = Xanthogranulomatous process (e.g. [[xanthogranulomatous pyelonephritis]], xanthogranulomatous cystitis), [[Granuloma|granulomatous inflammation]], [[papillary renal cell carcinoma]], infarction (prostate), [[granular cell tumour]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = yellow mass
| Grossing  =
| Site      = [[urinary bladder]] and elsewhere
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  = yellow lesion
| Prognosis  = benign
| Other      =
| ClinDDx    = [[renal cell carcinoma]], other tumours
}}
'''Malakoplakia''' is a thingy that typically arises in the [[urinary bladder]].
 
==General==
*Classically in the [[urinary bladder]].
**May be outside of urinary tract.<ref name=pmid17284117>{{Cite journal  | last1 = Yousef | first1 = GM. | last2 = Naghibi | first2 = B. | last3 = Hamodat | first3 = MM. | title = Malakoplakia outside the urinary tract. | journal = Arch Pathol Lab Med | volume = 131 | issue = 2 | pages = 297-300 | month = Feb | year = 2007 | doi = 10.1043/1543-2165(2007)131[297:MOTUT]2.0.CO;2 | PMID = 17284117 }}</ref>


==Gross==
==Gross==
*Yellow mass.<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70719-7 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70719-7]. Accessed on: 9 September 2010.</ref>
*Yellow mass.<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70719-7 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70719-7]. Accessed on: 9 September 2010.</ref>
**May mimic renal cell carcinoma.
**May mimic [[renal cell carcinoma]].


==Microscopic==
==Microscopic==
Features:<ref>{{Ref PBoD|1027}}</ref>
Features:<ref>{{Ref PBoD|1027}}</ref>
*Basophilic calcified lysosomes (Michaelis-Gutmann bodies) -- '''key feature'''.
**May be inside or outside of macrophages - often size of [[RBC]] or larger.
*Large foamy macrophages with granular cytoplasm.
*Large foamy macrophages with granular cytoplasm.
*Occasional multinucleated giant cell.
*Occasional multinucleated giant cell.
*Lymphocytes.  
*Lymphocytes.  
*Basophilic calcified lysosomes (Michaelis-Gutmann bodies).
**May be inside or outside of macrophages - often size of [[RBC]] or larger.


Images:
DDx:
*[http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675(06)70342-4&figureId=fig5&ecomponentId=mmc5 Malakoplakia (pathconsultddx.com)]
*Xanthogranulomatous process.
**If you cannot find the Michaelis-Gutmann bodies... it is a xanthogranulomatous process, e.g. [[xanthogranulomatous pyelonephritis]], xanthogranulomatous cystitis.
*[[Granuloma|Granulomatous inflammation]].
*[[Papillary renal cell carcinoma]].
*Infarction (prostate).
*[[Granular cell tumour]].<ref name=pmid19239951/>
 
===Images===
====Case====
<gallery>
Image:Michaelis-Gutmann_bodies_-_very_high_mag_-_cropped.jpg | Michaelis-Gutmann bodies - high mag. cropped (WC)
Image:Michaelis-Gutmann_bodies_-_very_high_mag.jpg | Michaelis-Gutmann bodies - high mag. (WC)
Image:malakoplakia bladder.jpg | Michaelis-Gutmann bodies - high mag. (WC)
</gallery>
 
====www====
*[http://granuloma.homestead.com/malakoplakia_bladder_s92-4486e.jpg Malakoplakia (granuloma.homstead.com)].
*[http://granuloma.homestead.com/malakoplakia_bladder_s92-4486e.jpg Malakoplakia (granuloma.homstead.com)].
*[http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=13&cat3=342&stype=d Michaelis-Gutmann bodies (gfmer.ch)].
==Stains==
*[[PAS-D stain]] +ve.<ref name=pmid17284117/>
*[[Von Kossa stain]] +ve.<ref name=pmid19239951>{{Cite journal  | last1 = Diapera | first1 = MJ. | last2 = Lozon | first2 = CL. | last3 = Thompson | first3 = LD. | title = Malacoplakia of the tongue: a case report and clinicopathologic review of 6 cases. | journal = Am J Otolaryngol | volume = 30 | issue = 2 | pages = 101-5 | month =  | year =  | doi = 10.1016/j.amjoto.2008.02.014 | PMID = 19239951 }}</ref>


==See also==
==See also==
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[[Category: Genitourinary pathology]]
[[Category: Genitourinary pathology]]
[[Category:Diagnosis]]
[[Category:Urothelium]]

Latest revision as of 15:51, 30 September 2018

Malakoplakia
Diagnosis in short

Malakoplakia with numerous Michaelis-Gutmann bodies. H&E stain.
LM basophilic calcified bodies approximately the size of a RBC (Michaelis-Gutmann body) - inside or outside of macrophages, large foamy macrophages with granular cytoplasm +/- multinucleation, lymphocytes
LM DDx Xanthogranulomatous process (e.g. xanthogranulomatous pyelonephritis, xanthogranulomatous cystitis), granulomatous inflammation, papillary renal cell carcinoma, infarction (prostate), granular cell tumour
Gross yellow mass
Site urinary bladder and elsewhere
Prevalence uncommon
Endoscopy yellow lesion
Prognosis benign
Clin. DDx renal cell carcinoma, other tumours

Malakoplakia is a thingy that typically arises in the urinary bladder.

General

Gross

Microscopic

Features:[3]

  • Basophilic calcified lysosomes (Michaelis-Gutmann bodies) -- key feature.
    • May be inside or outside of macrophages - often size of RBC or larger.
  • Large foamy macrophages with granular cytoplasm.
  • Occasional multinucleated giant cell.
  • Lymphocytes.

DDx:

Images

Case

  • Michaelis-Gutmann bodies - high mag. cropped (WC)

  • Michaelis-Gutmann bodies - high mag. (WC)

  • Michaelis-Gutmann bodies - high mag. (WC)

www

Stains

See also

References

  1. ↑ 1.0 1.1 Yousef, GM.; Naghibi, B.; Hamodat, MM. (Feb 2007). "Malakoplakia outside the urinary tract.". Arch Pathol Lab Med 131 (2): 297-300. doi:10.1043/1543-2165(2007)131[297:MOTUT]2.0.CO;2. PMID 17284117.
  2. ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70719-7. Accessed on: 9 September 2010.
  3. ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1027. ISBN 0-7216-0187-1.
  4. ↑ 4.0 4.1 Diapera, MJ.; Lozon, CL.; Thompson, LD.. "Malacoplakia of the tongue: a case report and clinicopathologic review of 6 cases.". Am J Otolaryngol 30 (2): 101-5. doi:10.1016/j.amjoto.2008.02.014. PMID 19239951.
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