Malakoplakia

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Malakoplakia
Other namesMalacoplakia
Michaelis-Gutmann bodies - very high mag - cropped.jpg
Micrograph showing the characteristic finding of malakoplakia (Michaelis–Gutmann bodies). H&E stain.

Malakoplakia (from Greek Malako "soft" + Plako "plaque") is a rare inflammatory condition which makes its presence known as a papule, plaque or ulceration that usually affects the genitourinary tract. [1] :274 However, it may also be associated with other bodily organs. It was initially described in the early 20th century as soft yellowish plaques found on the mucosa of the urinary bladder. Microscopically it is characterized by the presence of foamy histiocytes (called von Hansemann cells) with basophilic inclusions called Michaelis–Gutmann bodies.

Contents

It usually involves gram-negative bacteria. [2]

Causes

Malakoplakia is thought to result from the insufficient killing of bacteria by macrophages. Therefore, the partially digested bacteria accumulate in macrophages and leads to a deposition of iron and calcium. The impairment of bactericidal activity manifests itself as the formation of an ulcer, plaque or papule. Malakoplakia is associated with patients with a history of immunosuppression due to lymphoma, diabetes mellitus, kidney transplantation, or because of long-term therapy with systemic corticosteroids.[ citation needed ]

Diagnosis

As malakoplakia is a condition associated with chronic cystitis, it usually presents itself as a cystitis condition. The following investigations may help in making the diagnosis of malakoplakia:[ citation needed ]

Treatment

Treatments for malakoplakia include catheterizing the affected person with full aseptic precautions. Additionally, irrigating the bladder with distilled water three times daily with 3 way Foley's catheter and urinary antiseptics like pyridium may be used to help relieve urinary symptoms. Antibiotics such as trimethoprim-sulfamethoxazole or ciprofloxacin may be used. https://pubmed.ncbi.nlm.nih.gov/1553207/ https://pubmed.ncbi.nlm.nih.gov/1346012/

History

Leonor Michaelis and Carl Gutmann first described malakoplakia in 1902 after analyzing a patient's tumor at the request of David Paul von Hansemann. [3]

See also

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Pyelonephritis Medical condition

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Michaelis–Gutmann bodies

Michaelis–Gutmann bodies, (M-G bodies) are concentrically layered basophilic inclusions found in Hansemann cells in the urinary tract. They are 2 to 10 μm in diameter, and are thought to represent remnants of phagosomes mineralized by iron and calcium deposits.

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Cystitis glandularis

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Emphysematous cystitis Medical condition

Emphysematous cystitis is a rare type of infection of the bladder wall by gas-forming bacteria or fungi. The most frequent offending organism is E. coli. Other gram negative bacteria, including Klebsiella and Proteus are also commonly isolated. Fungi, such as Candida, have also been reported as causative organisms. Citrobacter and Enterococci have also been found to cause emphysematous cystitis. Although it is a rare type of bladder infection, it is the most common type of all gas-forming bladder infections. The condition is characterized by the formation of air bubbles in and around the bladder wall. The gas found in the bladder consists of nitrogen, hydrogen, oxygen, and carbon dioxide. The disease most commonly affects elderly diabetic and immunocompromised patients. The first case was identified in a post-mortem examination in 1888.

A urethral diverticulum is a condition where the urethra or the periurethral glands push into the connective tissue layers (fascia) that surround it.

References

  1. James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN   978-0-7216-2921-6.
  2. Liang Cheng; David G. Bostwick (2006). Essentials of anatomic pathology. Springer. pp. 1180–. ISBN   978-1-58829-461-6 . Retrieved 15 May 2010.
  3. McClure J (August 1983). "Malakoplakia". J Pathol. 140 (4): 275–330. doi:10.1002/path.1711400402. PMID   6308195.
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