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An unusual large abdominal malakoplakia following trauma: Diagnosed on FNAC
Surbhi Goyal1, Asmita Parihar, Vandana Puri
1Department of Pathology, University College of Medical Sciences & GTB Hospital, Delhi, India.
Abstract:
Malakoplakia is a rare chronic granulomatous inflammatory disease, related to immune deficiency and impaired bactericidal macrophage activity. Common sites of involvement include urinary bladder and kidney followed by gastrointestinal tract. We present an unusual case of abdominal malakoplakia diagnosed preoperatively on ultrasound-guided fine-needle aspiration cytology (FNAC). It presented as a large locally aggressive mass with extensive involvement of multiple bowel loops in an 18-year-old boy following blunt trauma to the abdomen. The demonstration of calcified laminated intracytoplasmic Michaelis-Gutman bodies in histiocytes is a reliable diagnostic feature of malakoplakia on FNAC smears, which can guide an appropriate medical management.
Insights
Malakoplakia, a rare inflammatory disease, can affect the abdomen. Ultrasound-guided fine-needle aspiration cytology (FNAC) aids in diagnosing this condition by identifying characteristic Michaelis-Gutman bodies.
Area of Science:
- Pathology
- Oncology
- Immunology
Background:
- Malakoplakia is a rare chronic granulomatous inflammatory disease.
- It is associated with immune deficiency and impaired macrophage function.
- Commonly affects the urinary tract and gastrointestinal tract.
Observation:
- An unusual case of abdominal malakoplakia is presented.
- The patient was an 18-year-old male with a large, aggressive abdominal mass.
- The mass involved multiple bowel loops following blunt abdominal trauma.
Findings:
- Preoperative diagnosis was achieved using ultrasound-guided fine-needle aspiration cytology (FNAC).
- Diagnostic feature: calcified laminated intracytoplasmic Michaelis-Gutman bodies in histiocytes.
- FNAC smears reliably demonstrated these pathognomonic bodies.
Implications:
- Early diagnosis of abdominal malakoplakia is possible with FNAC.
- Identification of Michaelis-Gutman bodies guides appropriate medical management.
- This case highlights an unusual presentation of malakoplakia in the abdomen.
