[Colonic malakoplakia: Rare disease that can mimic a consuntive syndrome]. / Malacoplaquia del colon: Rara enfermedad que puede presentarse como un sindrome consuntivo.

Colonic malacoplakia is an unusual cause of chronic diarrhea, and it may present as a consumptive disease. At the colon, it can induce ulcerative and erosive nodular lesions, that mimic other common granulomatous or infectious diseases. Diagnosis is support in biopsies showing groups of histiocytes, with typical Michaelis-Gutmann inclusions, which are positive with the Von Kossa stain. We present the case of a 55-year-old male, without associated diseases, who presented with diarrhea, weight loss and anemia, showing a very good clinical response to antibiotics.

Malakoplakia and primary immunodeficiency.

Malakoplakia, a rare granulomatous disease caused by impaired macrophage response, has been reported only rarely in children. We report 3 unique cases, with lesions occurring in unusual locations in children with primary immune deficiencies.

Malacoplaquia pulmonar associada à imunodeficiência por HTLV-1 e HIV / Pulmonary malakoplakia associated with immunodeficiency by HTLV-1 and HIV

Malakoplakia is a rare chronic inflammatory disease often confused with neoplasia. In this paper we report two cases of pulmonary Malakoplakia, both with typical clinical diagnosis of tuberculosis and lung cancer. A patient with human T-lymphotropic virus type I (HTLV-1) and diagnosis of adult T-cell leukemia/lymphoma, and another patient with human immunodeficiency virus (HIV), which was treated for tuberculosis, but, after pulmonary lobectomy, was evidenced Rodococosis equi, progressed to death...

Malacoplaquia é uma rara doença inflamatória crônica muitas vezes confundida com neoplasia. Neste artigo, relatam-se dois casos de malacoplaquia pulmonar, ambos com quadro clínico sugestivo de tuberculose e neoplasia pulmonar. Uma paciente com vírus T-linfotrópico humano tipo I (HTLV-1) e diagnóstico de leucemia/linfoma de células T do adulto, e um paciente com vírus da imunodeficiência humana (HIV), tratado para tuberculose, mas após lobectomia pulmonar foi evidenciado Rodococose equi, evoluindo para óbito...

Presentación de caso: Malacoplakia colónica y retroperitoneal asociada a adenocarcinoma de ciego / Case report: Colonic and retroperitoneal malacoplakia associated with adenocarcinoma of the cecum

La malacoplakia es una rara lesión granulomatosa crónica que puede estar asociada a un carcinoma colorrectal. Se presenta un caso de una mujer de 70 años con antecedente de colectomía derecha por un cáncer de ciego obstructivo y abscedado que invadía la pared abdominal y un asa de intestino delgado. La anatomía patológica informó un adenocarcinoma semidiferenciado pT4pN2pMo, con áreas de necrosis e infiltrados inflamatorios considerándose la cirugía paliativa. A los 5 meses presentó una masa palpable en flanco derecho fistulizada a piel, que se interpretó como neoplasia residual/recurrente. Comprometía la pared abdominal anterolateral, la región paravertebral y el músculo psoas derechos. Fue reoperada resecándose todo el tumor macroscópico, que comprendía una recidiva en intestino delgado con una malacoplakia extensa que involucraba el retroperitoneo, la anastomosis ileocólica y la pared abdominal, fistulizando a piel. Este caso confirma la asociación de carcinoma colorrectal y malacoplakia. Es importante conocer esta entidad dado que la extensa reacción inflamatoria que a veces rodea el carcinoma puede simular enfermedad avanzada, llevando a resecciones excesivas, o conductas paliativas por considerar imposible la cirugía con intento curativo. (AU)

Hemorragia masiva del aparato digestivo, secundaria a Malacoplaquia colónica ulcerada / Massive hemorrhage of the digestive tract secondary to ulcerated colonic malacoplakia

Reportamos un caso de malacoplaquia del colon que se presentó como hemorragia del tubo digestivo bajo masiva en una paciente femenina de 55 años de edad. Un colon por enema demostró lesiones polipoideas. La colonoscopía reveló nodulaciones pseudo-polipoideas color blanco amarillento, aparentando pequeñas pústulas que se extendían a todo el colon a partir de 2 cm del margen anal. La laparotomía reveló la presencia de masas lobuladas en la luz intestinal y lesiones amarillentas en forma de placas transmulares que infiltraban pared duodenal, así como gran cantidad de ganglios en todo el mesenterio. Realizamos protocolectomía. El estudio microscópico demostró infiltración masiva de histiocitos y numerosos cuerpos de Michaelis-Gutmann. Esta enfermedad se presenta casi exclusivamente en las vías urinarias y es extremadamente rara en el intestino. Enfatizamos en la importancia de un adecuado examen histológico que nos permita un diagnóstico correcto

[Massive hemorrhage of the digestive system secondary to ulcerated colonic malacoplakia]. / Hemorragia masiva del aparato digestivo, secundaria a malacoplaquia colonica ulcerada.

A case of malakoplakia of the colon in a 55-year-old female patient with a massive hemorrhage of the rectum is reported. A barium enema showed polypoid lesions (pseudopolyps). Colonoscopy revealed white-yellowish nodules simulating small pustulae all along the colon at 2 cm from the anal verge. A laparatomy disclosed lobulated intraluminal masses and yellowish lesions in the form of transcolonic plates infiltrating the duodenal wall as well as a fair amount of lymph nodes in the mesentery. We performed a proctocolectomy. The histologic study showed massive infiltrate of histiocytes and numerous Michaelis-Gutmann bodies. This disease is usually found in the urinary tract and rarely found in the colon. The importance of proper histologic examination in order to arrive at a correct diagnosis is emphasized.

[Intestinal malacoplakia in childhood. Report of 5 cases]. / Malacoplasia intestinal en la infancia. Informe de cinco casos.

We studied 5 children with intestinal malakoplakia who were seen during a period of 10 years. Four were male and one female. The main clinical manifestations were: chronic bloody and mucous diarrhea, abdominal pain and polypoid masses detected by rectal maneuver. Either the radiological study as well as endoscopy showed the presence of stenosis and polypoid masses (pseudopolyps). Two patients underwent laparotomy and a tumoral infiltration at the level of rectal-sigmoid and cecal appendix was found. Histological diagnosis proves to be definitive in these case. Drug treatment has been with bethanechol, trimethoprim-sulfamethoxazole in three patients. We conclude that intestinal malakoplakia is more common that ulcerative colitis in our children population attending at this institute. Therefore, the presence of intestinal malakoplakia must be ruled out in every child having chronic bloody and mucous diarrhea, presenting as well pseudopolyps.