[Medullary aplasia, sarcoidosis, and malacoplakia. A case report (author's transl)]

A 49-year-old man presented medullary aplasia, sarcoidosis, and malacoplakia as evidenced by biopsy. This is apparently the first case of this association to be described in the literature. Medullary aplasia is basically an aplasia of the erythroid series, though it may be a pure aplasia of the red cells alone. A histologic study of the left testicle removed because of an infectious orchiepidydimitis led to the discovery of malacoplakia. Skin nodules appeared later; two of them were extirpated and revealed the existence of sarcoidosis. There was no evidence of sarcoidosis at any other level. The immune mechanism involved in pure red cell aplasia with or without thymoma are well known. The association of malacoplakia and sarcoidosis, two similar conditions, is closely related to alterations in cell immunity. The possibility that common immune factors were present in this patient. After eliminating different therapeutic approaches used in other cases, an immunosuppresive therapy was applied.