Malacoplaquia diseminada: Evolución excepcional de una rara patología

Verónica Ventura; Lucía Curbelo; Daniel Puppo; Mercedes Perendones; Carlos Dufrechou

Authors

Verónica Ventura Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica 2, Medicina Interna. Residente
Lucía Curbelo Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica 2, Medicina Interna. Residente
Daniel Puppo Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica 2. Asistente
Mercedes Perendones Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica 2. Prof. Adj
Carlos Dufrechou Universidad de la República, Facultad de Medicina, Hospital Pasteur, Clínica Médica 2. Profesor

Keywords:

MALACOPLAKIA

Abstract

Malakoplakia is a chronic disease which primarily affects the Genitourinary tract, although it can appear in any body, usually self-limited and benign. Extravesical forms evidence a more aggressive course. Diagnostic is done through histopatology, being Michaelis-Guttmann bodies pathognomonic.
It is associated to chronic conditions, systemic diseases, immune depression and neoplasia. Medical treatment is non-specific and in the case of voluminous masses surgery is recommended. Prognosis is closely related to the localization of the process and the present of concomitant diseases.
The malakoplakia case reported is unusual given its clinical presentation (repeated high digestive hemorrhage), the topographical origin, lymph node commitment and the dissemination of the condition, as well as its malign evolution.

References

(1) Velásquez López JG, Vélez Hoyos A, Uribe Arcila JF. Malacoplaquia en urología; reporte de seis casos y revisión de la literatura. Actas Urol Esp 2006; 30(6): 610-8.
(2) Krauel L, García-Aparicio L, Pérez N, Laguna A, Camacho A, Vilar P, et al. Urinary and gastrointestinal malacoplakia in a 12 year old girl. Urology 2009; 73(1): 87-9.
(3) García Diez F, Benéitez Álvarez ME, Guerreiro González R, Casasola Chamorro J, Roa Luzuriaga JM, de Blas Gómez V, et al. Malacoplaquia renal: presentación de un nuevo caso. Arch Esp Urol 2005; 58(1): 63-6.
(4) Cury J, Coelho RF, Franco M, Srougi M. Renal parenchymal malacoplakia with pleural effusión. Clinics (São Paulo) 2007; 62(1): 87-8.
(5) Karasavvidou F, Potamianos SP, Barbanis S, Stathakis E, Psychos A, Kapsoritakis AN, et al. Malacolplakia of the colon associated with colonic adenocarcinoma diagnosed in colonic biopsies. World J Gastroenterol 2007; 13(45): 6109-11.
(6) Yousef GM, Naghibi B, Hamodat MM. Malacoplakia outside urinary tract. Arch Pathol Lab Med 2007; 131(2): 297-300.
(7) Cotran, R, Kumar V, Robbins S, eds. Robbins pathologic basis of disease. 6 ed. Philadelphia: WB Saunders, 1999: 1002.
(8) Fenoglio-Presier CM. Gatrointestinal pathology. 2 ed. Philadelphia: WB Saunders, 1999: 868.
(9) McClure J, Hadden DR, Mudd DG, Parks TG. Adrenocortical hyperactivity with disseminates malacoplakia. J Clin Pathol 1977, 30(3): 206-11.
(10) Ollier P, Bourrier P, Adil A, Anidjar M, Frija J. A case of lymph nodes involvement in malacoplakia of the bladder. J Radiol 2000; 81(2): 158-60.
(11) Nuciforo PG, Moneghini L, Braidotti P, Castoldi L, De Rai P, Bosari S. Malakoplakia of the pancreas with diffuse lymph-node involvement. Virchows Arch 2003; 442(1): 82-5.
(12) Pillay K, Chetty R. Malacoplakia in association with colorectal carcinoma: a series of four cases. Pathology 2002; 34(4): 332-5.
(13) De Prisco M, Guaiquirian L, Castillo S, Cutanda R, Barrios M, Martínez JC, et al. Malacoplaquia renal con comportamiento infiltrativo local. Rev Ven Urol 2004; 50(2): 85-6.
(14) Pozo Mengual B, Burgos Revilla FJ, Briones Mardones G, Linares Quevedo A, García-Cosio Piqueras M. Malacoplaquia vesical con afectación ganglionar y curso agresivo. Actas Urol Esp 2003; 27(2): 159-63.
(15) van Furth R, van't Wout JW, Wertheimer PA, Zwartendijk J. Ciprofloxacin for treatment of malakoplakia. Lancet 1992; 339(8786): 148-9.