POL Scientific / Bladder / Volume 11 / Issue 3 / DOI: 10.14440/bladder.2024.0036
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CASE REPORT

Recurrent bladder malakoplakia: A rare bladder lesion mimicking malignancy

Mukund Tinguria*
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1 Department of Pathology and Laboratory Medicine, Brantford General Hospital, Brantford, Ontario N3R 1G9, Canada
Bladder 2024 , 11(3), e21200018; https://doi.org/10.14440/bladder.2024.0036
Submitted: 3 September 2024 | Revised: 9 October 2024 | Accepted: 28 October 2024 | Published: 22 November 2024
© 2024 by the Bladder published by POL Scientific. Licensee POL Scientific, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Background: Malakoplakia is a rare granulomatous disease that commonly involves the genitourinary tract with the urinary bladder being the most frequently affected site. It is characterized by histiocytes containing distinct basophilic calcified inclusions called Michaelis–Gutmann bodies. It is believed to result from abnormally functioning macrophages, with inclusions representing calcifications around incompletely digested bacteria. Although its pathogenesis remains unknown, it is well-documented that the condition is associated with chronic urinary tract infections and immunosuppression. Grossly, it can present as soft, yellow plaques, nodules, bladder mass, or even without any visible lesion. It poses a huge diagnostic challenge as it tends to mimic malignancy. Case presentation: Described here is an 86-year-old female with recurrent bladder malakoplakia who presented with foul-smelling urine, hematuria, and dysuria. The clinicopathological features of this rare bladder lesion are described along with a review of the literature. Conclusion: Early identification of malakoplakia’s features by pathologists is essential for effective patient management. This condition should be considered in the differential diagnosis of bladder lesions, especially when Escherichia coli is present.

Keywords
Malakoplakia
Granulomatous disease
Urinary bladder
Michaelis–Gutmann bodies
Urinary tract infection
Neoplasm
Urinary tract pseudotumor
Hematuria
Rare disorder
Escherichia coli
Funding
None.
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Conflict of interest
The author declares no conflict of interest.
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Bladder, Electronic ISSN: 2327-2120 Print ISSN: TBA, Published by POL Scientific