Malacoplakia of the urinary bladder. Clinical case report

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Abstract

A clinical case of bladder malacoplakia in a 33-year-old woman, clinically manifested by dysuria and gross hematuria, is presented. Malacoplakia is a rare tumor-like granulomatous-inflammatory disease with a predominant lesion of the bladder mucosa. The literature describes extravesical forms of malacoplakia with involvement of the ureters, renal pelvis and calyces, prostate, testicles and their appendages, intestines and other organs. In women, the disease occurs 4 times more often than in men. The reasons for the development of malacoplakia are not fully understood. The main importance in its pathogenesis is attached to the infectious factor and immunosuppression. Diagnosis is based on histological examination of bladder biopsy specimens and the detection of Hansemann cells and Michaelis – Gutman bodies. Treatment of patients with malacoplakia consists of resection of the affected areas of the bladder and antibiotic therapy.

About the authors

Olga Yu. Barysheva

Petrozavodsk State University; Republican Hospital named after V.A. Baranov

Email: hosptherapy@mail.ru
ORCID iD: 0000-0002-2133-4849
SPIN-code: 4896-5434

Dr. Sci. (Med.), Professor of the Department of Hospital Therapy, Head of the Nephrological Unit

Russian Federation, 3, Pirogova st., Petrozavodsk, Republic of Karelia, 185019; Petrozavodsk

Ruslan N. Simanov

Petrozavodsk State University; Republican Hospital named after V.A. Baranov

Email: Ruslansimanov@yandex.ru
ORCID iD: 0000-0003-1246-7233
SPIN-code: 3747-8245

Postgraduate Student, Urologist

Russian Federation, 3, Pirogova st., Petrozavodsk, Republic of Karelia, 185019; Petrozavodsk

Andrej V. Bukalev

Republican Hospital named after V.A. Baranov

Author for correspondence.
Email: Dr.max-andy@yandex.ru
ORCID iD: 0000-0003-2080-3057
SPIN-code: 1230-2277

MD, Cand. Sci. (Med.), Pathologist

Russian Federation, 3, Pirogova st., Petrozavodsk, Republic of Karelia, 185019

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Supplementary files

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2. Fig. 1. Contrast-enhanced magnetic resonance image of the pelvis: а – sagittal projection; b – axial projection. The arrows indicate the thickening of the bladder wall

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3. Fig. 2. Multislice computed tomography of the pelvis. Axial projection: а – native, b – with contrast enhancement. The arrow indicates the thickening of the bladder wall

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4. Fig. 3. Cystoscopic picture of malacoplakia of the bladder during surgery: а – left side wall, b – back wall

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5. Fig. 4. Histological pattern of the malacoplakia of the bladder. Hansemann cells with Michaelis–Gutman bodies. Staining with hematoxylin and eosin. Magnification ×200 (а), ×400 (b)

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6. Fig. 5. Malacoplakia of the bladder. Michaelis–Gutman bodies. Staining with Schiff reagent, PAS-reaction. Magnification ×400

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