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Malakoplakia Presenting as a Mass in the Transplanted Kidney: A Malignancy Mimicker on PET/CT
Lokeshwaran Madurai Kalimuthu1, Manish Ora, Aftab Hasan Nazar
1From the Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Abstract:
Malakoplakia is a rare inflammatory condition that can affect many organ systems, including the genitourinary tract. It is associated with impaired immune function. Isolated renal parenchymal involvement has been reported in very few cases. Urinary tract and digestive malakoplakia have been reported in transplant recipients, but the involvement of transplant itself is rare. Variable clinical manifestations and nonspecific radiological appearance make the diagnosis difficult. The differential diagnosis includes infective etiologies and malignancy. We report a case of renal allograft malakoplakia, mimicking as a malignancy on F-FDG PET/CT.
Insights
Malakoplakia is a rare inflammatory condition affecting the genitourinary tract, often linked to immune dysfunction. This case highlights renal allograft malakoplakia mimicking malignancy on F-FDG PET/CT imaging.
Area of Science:
- Nephrology
- Transplant Surgery
- Pathology
Background:
- Malakoplakia is a rare inflammatory disorder impacting various organs, notably the genitourinary tract.
- It is frequently associated with compromised immune function.
- While genitourinary and digestive malakoplakia occur in transplant recipients, direct involvement of the transplant itself is exceptionally rare.
Observation:
- This report details a unique instance of malakoplakia affecting a renal allograft.
- The condition presented with variable clinical signs and non-specific radiological features, complicating diagnosis.
- Diagnostic challenges included differentiating from infective causes and malignancies.
Findings:
- The renal allograft malakoplakia mimicked malignant neoplasms on F-FDG PET/CT scans.
- This imaging similarity posed a significant diagnostic challenge, potentially leading to misdiagnosis.
Implications:
- This case underscores the importance of considering rare conditions like malakoplakia in transplant recipients, even with atypical presentations.
- Accurate diagnosis is crucial to avoid inappropriate treatment for presumed malignancy.
- Further research into the imaging characteristics of malakoplakia in allografts may improve diagnostic accuracy.
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