Malakoplakia of the small intestine presenting as an abdominal mass

Abstract

Malakoplakia is a rare chronic granulomatous disease that typically involves the urinary and gastrointestinal tracts of immunocompromised individuals. Characteristic histologic features include von Hansemann cells and Michaelis-Gutmann bodies. Clinical manifestations, based on the organ system effected, range from cutaneous lesions, irritative urinary symptoms, and hematochezia. We report a rare example of malakoplakia presenting as an abdominal mass with extensive intestinal and pelvic involvement complicated by a superficial polymicrobial abscess. This case report aims to describe the proposed pathogenesis, variable clinical presentation, and surgical management of malakoplakia.

Keywords: Michaelis–Gutmann bodies; abdominal mass; malakoplakia; von Hansemann cells.

Figure 1

Computed tomography of the abdomen and pelvis in the axial (A) and coronal (B) planes demonstrating a 7.8 × 4.3 cm mass along the right pelvic sidewall and necrotic mass in the anterior abdominal wall with a cutaneous fistula.