Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Jul 18;15(1):88.
doi: 10.1186/s13000-020-01014-x.

Unexpected endometrial malacoplakia related to abortion and placental rests retention: a case report

Antonio d'Amati  1 , Emilio Bellitti  2 , Leonardo Resta  3
Affiliations
Case Reports

Unexpected endometrial malacoplakia related to abortion and placental rests retention: a case report

Antonio d'Amati et al. Diagn Pathol. .

Abstract

Background: Malacoplakia is a rare chronic inflammatory disease. The name derives from the Greek "μαλακός" meaning "soft" and "πλάξ" meaning "plaque", describing its usual macroscopic presentation as a friable yellow soft plaque. It was first described by von Hansemann in 1901 and by Michaelis and Gutmann in 1902. The urinary system is the most commonly involved site. Female genital tract involvement is extremely rare. Treatment is prevalently based on antibiotics with surgical intervention sometimes necessary. Prognosis is usually good, but relapse may frequently occur.

Case presentation: This report illustrates the first case of endometrial malacoplakia in a 40 years-old patient who received endometrial curettage due to the retention of placental rests following an abortion. After conspicuous vaginal sero-hematic secretions, the patient received a further curettage. The histological examination did not show any retention of chorionic rests, but an endometrial and myometrial infiltration of histiocytes with large granular cytoplasm within a chronic inflammatory background. Immunoreactivity for CK-pool was negative, while CD68 immunostaining was strongly positive.

Conclusions: Malacoplakia of endometrium is an extremely rare condition, with few cases reported in the whole international literature. In this paper, we present the first case associated to an abortion followed by endometrial curettage procedures. This rare disease should always be attentively examined, considering, among differential diagnoses, uterine neoplasms or physiological conditions such as cumulus of foamy macrophages in the endometrium.

Keywords: Abortion; Case report; Endometrial diseases; Malacoplakia; Pathology.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Chronic inflammatory infiltrate, mostly composed of histiocytes with abundant granular cytoplasm and basophilic bodies. (H&E stain, 100x)
Fig. 2
Fig. 2
Diffuse cytoplasmic staining in histiocytic elements. (Periodic acid-Schiff stain, 100x)
Fig. 3
Fig. 3
Strong cytoplasmic positivity for CD68, highlighting several histiocytes. (100x)
Fig. 4
Fig. 4
Negative immunoreaction for CK-pool. (100x)
See this image and copyright information in PMC

References

    1. Jung YS, Chung DY, Kim EJ, Cho NH. Ultrastructural evidence of the evolutional process in malakoplakia. Histol Histopathol. 2020;35(2):177–184. - PubMed
    1. Biggar WD, Keating A, Bear RA. Malakoplakia: evidence for an acquired disease secondary to immunosuppression. Transplantation. 1981;31(2):109–112. doi: 10.1097/00007890-198102000-00003. - DOI - PubMed
    1. Liu J, Hao S, Chen X, Zhao H, Du L, Ren H, et al. Human placental trophoblast cells contribute to maternal–fetal tolerance through expressing IL-35 and mediating iTR35 conversion. Nat Commun. 2019;10(1):4601. doi: 10.1038/s41467-019-12484-z. - DOI - PMC - PubMed
    1. Naruse K, Innes BA, Bulmer JN, Robson SC, Searle RF, Lash GE. Secretion of cytokines by villous cytotrophoblast and extravillous trophoblast in the first trimester of human pregnancy. J Reprod Immunol. 2010;86(2):148–150. doi: 10.1016/j.jri.2010.04.004. - DOI - PubMed
    1. Chadha S, Vuzevski VD, ten Kate FJ. Malakoplakia of the endometrium: a rare cause of postmenopausal bleeding. Eur J Obstet Gynecol Reprod Biol. 1985;20(3):181–189. doi: 10.1016/0028-2243(85)90018-8. - DOI - PubMed

Publication types

LinkOut - more resources