2017 Volume 59 Issue 10 Pages 2514-2520
Malakoplakia is a rare form of chronic inflammatory disease. It is pathologically characterized by the accumulation of macrophages containing intracytoplasmic structures with iron and calcium deposits (Michaelis-Gutmann bodies). Malakoplakia most commonly occurs in the urinary tract system such as the bladder. Only a few cases of malakoplakia have been reported in the gastrointestinal tract.
A 72-year-old woman was receiving steroid therapy for interstitial pneumonia. Her blood test showed enhancement of inflammatory reaction. Therefore, we performed positron emission tomography (PET) /computed tomography (CT), which showed accumulations in the ascending colon and left kidney. Colonoscopy showed a collection of squamous elevated lesions with a yellowish-white tone of 5-7 mm in diameter from the cecum to the ascending colon, as well as a 10mm Isp-like polypoid lesion in the ascending colon. Histopathology of biopsy specimens of the lesions in both the kidney and large intestine revealed Periodic Acid Schiff-positive histiocytes and Michaelis-Gutmann bodies. Thus, we made the diagnosis of renal and colonic malakoplakia. The patient was treated with ascorbic acid and ciprofloxacin, and the lesions decreased in size.
