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Rectal malakoplakia.

Ted George Achufusi1, Kegan Jessamy1, Philip Chebaya1

  • 1Department of Internal Medicine, State University of New York Upstate Medical UniversitySyracuseNew York.

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|July 18, 2020
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Summary

Malakoplakia, a rare granulomatous disease, can affect the gastrointestinal tract. This case highlights rectal malakoplakia presenting as a polypoid mass with painless hematochezia.

Keywords:
ColonMichealis-Gutman bodiescolonoscopymacrophagesmalakoplakia

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Area of Science:

  • Gastroenterology
  • Pathology
  • Rare Diseases

Background:

  • Malakoplakia is a rare chronic granulomatous condition.
  • Gastrointestinal involvement is a known manifestation, second to the urinary tract.
  • Early diagnosis and management are crucial for patient outcomes.

Observation:

  • A male patient presented with painless hematochezia.
  • Colonoscopy revealed a fungating, polypoid, circumferential rectal mass.
  • The mass was nonobstructing despite its size.

Findings:

  • Histopathological examination confirmed malakoplakia.
  • Microscopic findings included characteristic Michaelis-Guttmann bodies.
  • The lesion's macroscopic appearance mimicked other colorectal pathologies.

Implications:

  • This case underscores the importance of considering malakoplakia in the differential diagnosis of rectal masses.
  • Awareness of its varied presentations can improve diagnostic accuracy.
  • Further research into optimal treatment strategies for gastrointestinal malakoplakia is warranted.