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Case Reports
. 2024 Sep 11;11(9):e01486.
doi: 10.14309/crj.0000000000001486. eCollection 2024 Sep.

Malakoplakia in a Transplanted Liver

Zaid Ansari  1 , Akram Ahmad  1 , Pablo A Bejarano  2 , Antonio Pinna  3 , Xaralambos Zervos  1
Affiliations
Case Reports

Malakoplakia in a Transplanted Liver

Zaid Ansari et al. ACG Case Rep J. .

Abstract

Malakoplakia is a rare acquired histiocytic disorder first described in the urinary bladder. There have been 8 cases reported involving the liver, and this is the first reported case of malakoplakia involving an adult transplanted liver. We report a 63-year-old man with a medical history of orthotopic liver transplantation who presented with fever, chills, and abdominal pain. Imaging found confluent microabscesses in the right lobe of the liver that persisted despite prolonged antibiotics. He was taken to the operating room for a segment 6 hepatectomy of the abscess. Histologically, the inflammatory process showed malakoplakia.

Keywords: Malakoplakia; liver abscess; liver mass; liver transplant.

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Figures

Figure 1.
Figure 1.
Abdominal/pelvic computed tomography with contrast: coronal view. Yellow arrow pointing towards complex mass/cluster of microabscesses in the liver.
Figure 2.
Figure 2.
Computed tomography with contrast liver protocol: axial view. Yellow arrow pointing towards complex mass/cluster of microabscesses in the liver.
Figure 3.
Figure 3.
Abdominal magnetic resonance imaging without contrast: coronal view. Yellow arrow pointing towards complex mass/cluster of microabscesses in the liver.
Figure 4.
Figure 4.
Abdominal magnetic resonance imaging without contrast: axial view. Yellow arrow pointing towards complex mass/cluster of microabscesses in the liver.
Figure 5.
Figure 5.
The 7 cm resected liver shows clustering plaque nodules of tan-white soft material. This is the first gross image of liver malakoplakia ever published. Black arrows indicates tan white plaque/nodules of malakoplakia.
Figure 6.
Figure 6.
Cytoplasm of histiocytes contains eye-like targetoid inclusions corresponding to Michaelis-Gutmann bodies (hematoxylin and eosin, 200×). Black arrow showing michaelis-gutmann bodies.
Figure 7.
Figure 7.
The inclusions are highlighted with a Prussian iron stain (100×). Black arrows pointing towards iron stain positive inclusions.
Figure 8.
Figure 8.
The inclusions are highlighted with a von Kossa stain indicating their calcium content (100×). Black arrow showing a positive von Kossa stain.
See this image and copyright information in PMC

References

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