Fine-needle aspiration cytology of bilateral renal malakoplakia

Mamta Gupta, Sudhakar K Venkatesh, Anant Kumar, Rakesh Pandey

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Isolated bilateral renal malakoplakia in the absence of concomitant involvement of the urinary tract is a rare occurrence. We report imaging, cytologic, and histologic findings of such a case diagnosed initially by fine-needle aspiration (FNA) cytology. A 26-yr-old female presented with pain in the left flank, fever, anorexia, and weight loss for the past 2 mo. A left lumbar lump was palpable on physical examination. Imaging studies showed an enlarged nonfunctioning left kidney and a small lesion in the right kidney with preserved function. FNA from both kidneys yielded purulent material positive for E. coli on culture. The smears were inflammatory, with a predominance of neutrophilic polymorphs and numerous histiocytes along with some intracellular and extracellular Michaelis-Guttman bodies, which were highlighted with the use of a PAS stain. Histology of the nephrectomy specimen showed ill-defined nodules, composed of foamy histiocytes intermingled with neutrophils, plasma cells, and many variably sized concentric laminated bodies. The right-side lesion resolved with the use of broad-spectrum antibiotics in conjunction with ascorbic acid and bethanecol. When imaging studies are suggestive of a chronic inflammatory process, renal malakoplakia must always be considered in the differential diagnosis even if aspirated material shows a predominance of polymorphonuclear leukocytes. The use of special stains like PAS, Von Kossa, and Perl's helps in reaching the correct diagnosis.

Original languageEnglish (US)
Pages (from-to)116-117
Number of pages2
JournalDiagnostic Cytopathology
Volume31
Issue number2
DOIs
StatePublished - Aug 2004
Externally publishedYes

Fingerprint

Malacoplakia
Fine Needle Biopsy
Cell Biology
Kidney
Histiocytes
Neutrophils
Coloring Agents
Bethanechol
Flank Pain
Anorexia
Plasma Cells
Nephrectomy
Urinary Tract
Ascorbic Acid
Physical Examination
Weight Loss
Histology
Differential Diagnosis
Fever
Escherichia coli

Keywords

  • Cytology
  • Diagnosis
  • FNAB
  • Kidney
  • Malakoplakia

ASJC Scopus subject areas

  • Anatomy

Cite this

Fine-needle aspiration cytology of bilateral renal malakoplakia. / Gupta, Mamta; Venkatesh, Sudhakar K; Kumar, Anant; Pandey, Rakesh.

In: Diagnostic Cytopathology, Vol. 31, No. 2, 08.2004, p. 116-117.

Research output: Contribution to journalArticle

Gupta, Mamta ; Venkatesh, Sudhakar K ; Kumar, Anant ; Pandey, Rakesh. / Fine-needle aspiration cytology of bilateral renal malakoplakia. In: Diagnostic Cytopathology. 2004 ; Vol. 31, No. 2. pp. 116-117.
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