Endoscopic mucosal resection of a rectal malakoplakia in a healthy adult

Harunobu Sato, Tetsuya Tsukamoto, Yoshihisa Mizuno, Tomoaki Ichikawa, Yoshihito Kotani, Katsuyuki Honda, Kouhei Hatta, Makoto Kuroda

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Malakoplakia in the gastrointestinal tract is rare in healthy young people without underlying disease. Sufficient tissue is required for accurate diagnosis. We describe a malakoplakia that developed in a healthy young woman and was treated by endoscopic mucosal resection (EMR). A 40-year-old woman with a history of taking oral contraceptives until one year earlier was referred to our hospital with anal bleeding and constipation. A colonoscopy carried out at our another hospital 18 months earlier disclosed no abnormal findings. Colonoscopy at presentation revealed a yellowish-white tumor, 5 mm in diameter, in the rectum. The lesion was slightly protruded and had a smooth flat surface, without erosion or ulceration. EMR was carried out for a definitive diagnosis. Histopathological examination showed that the tumor contained granular histiocytes, positive for CD68 and negative forcytokeratin (AE1/AE3). Several histiocytes contained intracytoplasmic round bodies (Michaelis-Gutmann bodies), which reacted positively with periodic acid-Schiff and calcium (Von Kossa) stains. Intracytoplasmic Escherichia coli (von Hansemann bodies) were identified by Giemsa staining. Based on these results, the tumor in the rectum was diagnosed as a malakoplakia. Following EMR, the patient did not receive further treatment for malakoplakia because she had no symptoms associated with malakoplakia. She has been well for more than 9 months, with no symptoms of disease. Awareness of colorectal malakoplakia is important in patients taking steroids, including oral contraceptives.

Original languageEnglish
Pages (from-to)749-751
Number of pages3
JournalDigestive Endoscopy
Volume26
Issue number6
DOIs
Publication statusPublished - 01-11-2014

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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