Malacoplakia of the female genital tract

Malacoplakia is an uncommon chronic granulomatous inflammation which most frequently involves the urinary bladder of middle-aged women and rarely affects the genital tract. In this paper 10 cases of female genital malacoplakia are reviewed, seven of which have been reported previously in the literature. Genital malacoplakia usually occurs in women 60 years of age or older and most frequently affects the vagina. Vaginal bleeding is a common presenting complaint and the lesion may simulate a malignancy. Four of the 10 patients were receiving corticosteroids at the time of diagnosis. Escherichia coli was cultured from urine or from the lesion itself in half of the cases. The disease appears to be an acquired defect in bactericidal function of histiocytes. Antibiotic therapy and surgical excision are effective, although a recurrence developed in one patient and was successfully re-excised.