Adrenal gland and paraganglia
Other benign cortical lesions
Malakoplakia

Author: Lan L. Gellert, M.D., Ph.D. (see Authors page)

Revised: 7 December 2016, last major update December 2016

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed search: adrenal malakoplakia

Cite this page: Malakoplakia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/adrenalmalakoplakia.html. Accessed January 17th, 2017.
Definition / General
  • Rare histiocytic disease, commonly presents in GU tract
  • Extremely rare in adrenal gland (only 2 case reports in the literature)
Essential Features
  • Histiocytic disease which is extremely rare in adrenal gland
  • Due to an abnormal macrophage response to E. coli infection
  • Marked histiocytic inflammation
  • Intracellular round or concentrically laminated Michaelis-Gutmann bodies highlighted by von Kossa stain
Etiology
  • Caused by an abnormal macrophage response to gram negative bacteria (e.g. E. coli or Proteus) that results in intracellular deposition of iron and calcium (Michaelis-Gutmann bodies)
Clinical Features
  • Fever and general malaise
Diagnosis
  • Presence of Michaelis-Gutmann bodies generally required for a diagnosis of malakoplakia
Case Reports
Treatment
  • Antibiotics
  • Surgical excision
Gross Images
Images hosted on other servers:

Adrenal gland replaced
by tumor-like
malakoplakic tissue

Micro Description
  • Marked histiocytic inflammation, often admixed with neutrophils, lymphocytes and plasma cells
  • Intracellular round or concentrically laminated inclusions of Michaelis-Gutmann bodies highlighted by von Kossa stain
Micro Images
Images hosted on PathOut server:

Courtesy of Dr. Lan L. Gellert, M.D., Ph.D.:

Laminated Michaelis-Gutmann bodies

Histiocytes with
abundant coarsely
granular cytoplasm
and uniform nuclei



Images hosted on other servers:

Laminated Michaelis-Gutmann bodies

Histiocytes with
abundant coarsely
granular cytoplasm
and uniform nuclei

Positive Stains
Negative Stains
Electron Microscopy Images
Images hosted on other servers:

Various images

Differential Diagnosis