Rectal malacoplakia in a patient with Hodgkin's disease. Report of a case and review of the literature.
A 37-year-old man was found to have classic malacoplakia of the rectum after three courses of chemotherapy for stage IV Hodgkin's disease. Sigmoidoscopy with excisional biopsy was performed because of rectal bleeding. The biopsy specimen of the rectal lesion showed focal extensive granulomatous changes with large macrophages containing round, dense Michaelis-Gutmann bodies. Electromicroscopy demonstrated calcifying spheres with laminated concertric structures (Michaelis-Gutmann bodies) and coliform bacillus in the cytoplasm of macrophages (Von Hansemann bodies). Review of the literature revealed that association of malacoplakia with Hodgkin's disease has never been documented, although it has been reported to be associated with conditions such as malignancy, organ transplantation, collagen disease, and leukemia. The possible role of immune disturbance as an underlying cause of malacoplakia is discussed.
D000328:Adult; D006689:Hodgkin Disease / Q000150:complications* / Q000473:pathology; D006801:Humans; D008287:Malacoplakia / Q000150:complications* / Q000276:immunology / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D012002:Rectal Diseases / Q000150:complications*; D012007:Rectum / Q000648:ultrastructure; D013601:T-Lymphocytes / Q000276:immunology