Colonic Malakoplakia: A Rare Finding in a Healthy Male

Area of Science:

• Gastroenterology
• Pathology
• Rare Diseases

Background:

• Malakoplakia is a rare chronic granulomatous disease affecting multiple organs, with the gastrointestinal tract being a common site outside the urinary tract.
• Colonic malakoplakia is infrequently reported and often associated with systemic diseases or colorectal adenocarcinoma.
• Most reported colonic malakoplakia cases involve the rectum, sigmoid, or right colon.

Observation:

• A 65-year-old male presented with abdominal pain and unintentional weight loss.
• Colonoscopy revealed an isolated, large, flat, soft, and pale lesion in the transverse colon.
• Physical examination findings were unremarkable.

Findings:

• Histopathological examination showed lamina propria expansion with inflammatory cells and polygonal cells.
• Von Kossa stain revealed intracytoplasmic granular inclusions.
• Numerous Michaelis-Gutmann bodies were identified, confirming the diagnosis of colonic malakoplakia.

Implications:

• This case represents a rare instance of isolated transverse colonic malakoplakia diagnosed through endoscopic specimens.
• Highlights the importance of considering malakoplakia in the differential diagnosis of colonic lesions, even when isolated.
• Contributes to the understanding of rare gastrointestinal manifestations of malakoplakia.