Abstract

Background: Malakoplakia is a rare chronic granulomatous inflammatory disease. It is mainly observed in the genitourinary tract, but involvement of other organs/sites has been reported, including GI tract which is the second most common site of involvement. Histologically, Michaelis-Gutmann bodies are pathognomonic for the disease.
Case Report: We report the case of a 57-year-old male who presented in the clinic of gastroenterology department for colorectal cancer screening via colonoscopy. Findings from colonoscopy included a 10 mm sessile polyp at hepatic fl exure, a 10 mm pedunculated polyp of sigmoid colon and a 8 mm sessile polyp of sigmoid colon all removed via snare polypectomy. Pathologic findings of the first polyp was tubulovillous adenoma. Hematoxylin and eosin stained sections of the other polyps showed hyperplastic polyps with expansion of the lamina propria by a diffuse infiltrate of foamy macrophages with few admixed giants cells, neutrophils, lymphocytes and plasma cells. Within and in between the macrophages were spherical eosinophilic structures surrounded by clear halo, which were consistent with Michaelis-Gutmann bodies confirming the diagnosis of malakoplakia.
Conclusions: The association of malakoplakia with colonic adenomatous polyps is very rare with only 4 cases reported in the literature so far. However, to our knowledge, this is the first case reported in the medical literature of colon malakoplakia in association with hyperplastic polyps.

Keywords: malakoplakia, Michaelis-Gutmann body, hyperplastic polyp, immunosuppresion