Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1976 Apr;29(4):354–363. doi: 10.1136/jcp.29.4.354

Clinical and laboratory studies into the pathogenesis of malacoplakia.

K J Lewin, W R Fair, R T Steigbigel, C D Winberg, M J Droller
PMCID: PMC476062  PMID: 1084356

Abstract

Three cases of malacoplakia are described. Electron microscopic studies revealed intact bacteria or bacteria in varying states of degradation within phagolysosomes of the malacoplakic macrophages. Michaelis-Gutmann bodies arise within the phagolysosomes. These findings suggest that the bacteria incorporated within the phagolysosomes persist as dense amorphous aggregates which later become encrusted with calcium phosphate crystals to form the laminated Michaelis-Gutmann bodies. Possible explanations for the unusual macrophage response in malacoplakia are: (1) infection with an unusual strain of bacteria, (2) an immunological abnormality affecting intracellular killing of organisms, and (3) an abnormality affecting intracellular digestion of organisms. In considering each of the possibilities, we have been unable to detect any unusual strain of infecting organisms in association with malacoplakia, and in vitro studies have revealed normal T lymphocyte response to mitogen and normal monocyte bactericidal capacity. According to the history, each patient had reason to have a compromised immune status; in only one, however, was this demonstrated.

Full text

PDF

Images in this article

356Image
on p.356
357Image
on p.357
357Image
on p.357
358Image
on p.358
359Image
on p.359
360Image
on p.360
361Image
on p.361

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BLACKWELL J. B., FINLAY-JONES L. R. Malakoplakia of the testis. J Pathol Bacteriol. 1959 Oct;78:571–574. doi: 10.1002/path.1700780227. [DOI] [PubMed] [Google Scholar]
  2. BLEISCH V. R., KONIKOV N. F. Malakoplakia of urinary bladder; report of four cases and discussion of etiology. AMA Arch Pathol. 1952 Oct;54(4):388–397. [PubMed] [Google Scholar]
  3. Blackshear W. M., Jr Malakoplakia of the appendix: a case report. Am J Clin Pathol. 1970 Feb;53(2):284–287. doi: 10.1093/ajcp/53.2.284. [DOI] [PubMed] [Google Scholar]
  4. Di Silvio T. V., Bartlett E. F. Malacoplakia of the colon. Arch Pathol. 1971 Sep;92(3):167–171. [PubMed] [Google Scholar]
  5. Dockerty M. B. Primary malakoplakia of the colon. Mayo Clin Proc. 1972 Feb;47(2):114–116. [PubMed] [Google Scholar]
  6. Finlay-Jones L. R., Blackwell J. B., Papadimitriou J. M. Malakoplakia of the colon. Am J Clin Pathol. 1968 Sep;50(3):320–329. doi: 10.1093/ajcp/50.3.320. [DOI] [PubMed] [Google Scholar]
  7. GONZALEZ ANGULO A., CORRAL E., GARCIA TORRES R., QUIJANO M. MALAKOPLAKIA OF THE COLON. Gastroenterology. 1965 Mar;48:383–387. [PubMed] [Google Scholar]
  8. Green W. O., Jr Malacoplakia of the epididymis (without testicular involvement). The first reported case. Arch Pathol. 1968 Oct;86(4):438–441. [PubMed] [Google Scholar]
  9. Gupta R. K., Schuster R. A., Christian W. D. Autopsy findings in a unique case of malacoplakia. A cytoimmunohistochemical study of Michaelis-Gutmann bodies. Arch Pathol. 1972 Jan;93(1):42–48. [PubMed] [Google Scholar]
  10. HAUKOHL R. S., CHINCHINIAN H. Malakoplakia of the testicle; report of a case. Am J Clin Pathol. 1958 May;29(5):473–478. doi: 10.1093/ajcp/29.5.473. [DOI] [PubMed] [Google Scholar]
  11. HOFFMANN E., GARRIDO M. MALAKOPLAKIA OF THE PROSTATE: REPORT OF A CASE. J Urol. 1964 Oct;92:311–313. doi: 10.1016/S0022-5347(17)63956-9. [DOI] [PubMed] [Google Scholar]
  12. Lambird P. A., Yardley J. H. Urinary tract malakoplakia: report of a fatal case with ultrastructural observations of Michaelis-Gutman bodies. Johns Hopkins Med J. 1970 Jan;126(1):1–14. [PubMed] [Google Scholar]
  13. Le Charpentier Y., Le Charpentier M., Franc B., Galian P., Abelanet R. Données fournies par l'étude ultrastructurale de deux observations de malakoplakie. Virchows Arch A Pathol Pathol Anat. 1973 Apr 19;359(2):157–170. [PubMed] [Google Scholar]
  14. Leclerc J. L., Bernier L. Malacoplasie cutanée. Union Med Can. 1972 Mar;101(3):471–473. [PubMed] [Google Scholar]
  15. Lewin K. J., Harell G. S., Lee A. S., Crowley L. G. Malacoplakia. An electron-microscopic study: demonstration of bacilliform organisms in malacoplakic macrophages. Gastroenterology. 1974 Jan;66(1):28–45. [PubMed] [Google Scholar]
  16. Lou T. Y., Teplitz C. Malakoplakia: pathogenesis and ultrastructural morphogenesis. A problem of altered macrophage (phagolysosomal) response. Hum Pathol. 1974 Mar;5(2):191–207. doi: 10.1016/s0046-8177(74)80066-3. [DOI] [PubMed] [Google Scholar]
  17. MELICOW M. M. Malacoplakia: report of case, review of literature. J Urol. 1957 Jul;78(1):33–40. doi: 10.1016/S0022-5347(17)66396-1. [DOI] [PubMed] [Google Scholar]
  18. McClurg F. V., D'Agostino A. N., Martin J. H., Race G. J. Ultrastructural demonstration of intracellular bacteria in three cases of malakoplakia of the bladder. Am J Clin Pathol. 1973 Dec;60(6):780–788. doi: 10.1093/ajcp/60.6.780. [DOI] [PubMed] [Google Scholar]
  19. NATION E. F. Malakoplakia of the urinary tract. J Urol. 1956 Nov;76(5):576–582. doi: 10.1016/S0022-5347(17)66737-5. [DOI] [PubMed] [Google Scholar]
  20. Ranchod M., Kahn L. B. Malacoplakia of the gastrointestinal tract. Arch Pathol. 1972 Jul;94(1):90–97. [PubMed] [Google Scholar]
  21. Rywlin A. M., Ravel R., Hurwitz A. Malakoplakia of the colon. Am J Dig Dis. 1969 Jul;14(7):491–499. doi: 10.1007/BF02283889. [DOI] [PubMed] [Google Scholar]
  22. SCOTT E. V., SCOTT W. F., Jr A fatal case of malakoplakia of the urinary tract. J Urol. 1958 Jan;79(1):52–56. doi: 10.1016/S0022-5347(17)66233-5. [DOI] [PubMed] [Google Scholar]
  23. SMITH B. H. MALACOPLAKIA OF THE URINARY TRACT: A STUDY OF TWENTY-FOUR CASES. Am J Clin Pathol. 1965 May;43:409–417. doi: 10.1093/ajcp/43.5.409. [DOI] [PubMed] [Google Scholar]
  24. Steigbigel R. T., Lambert L. H., Jr, Remington J. S. Phagocytic and bacterial properties of normal human monocytes. J Clin Invest. 1974 Jan;53(1):131–142. doi: 10.1172/JCI107531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. TERNER J. Y., LATTES R. MALAKOPLAKIA OF COLON AND RETROPERITONEUM. REPORT OF A CASE WITH A HISTOCHEMICAL STUDY OF THE MICHAELIS-GUTMAN INCLUSION BODIES. Am J Clin Pathol. 1965 Jul;44:20–31. doi: 10.1093/ajcp/44.1.20. [DOI] [PubMed] [Google Scholar]
  26. Yunis E. J., Estevez J. M., Pinzon G. J., Moran T. J. Malacoplakia. Discussion of pathogenesis and report of three cases including one of fatal gastric and colonic involvement. Arch Pathol. 1967 Feb;83(2):180–187. [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES