title: Pulmonary malakoplakia diagnosed by fine needle aspiration. A case report.
abstract: BACKGROUND
  Pulmonary malakoplakia is an uncommon disorder, with 24 previously reported cases, only 4 of which were diagnosed by bronchial washings, bronchial brushings or aspiration cytology. We report a case that was diagnosed initially by computed tomography (CT)-guided fine needle aspiration (FNA) cytology.
  
  
  METHODS
  A 56-year-old male with follicular small cleaved cell lymphoma had a 10-cm left lower lobe mass compressing the main bronchus to that lobe. A transthoracic, CT-guided FNA specimen consisted predominantly of foamy macrophages, many of which contained typical Michaelis-Gutmann bodies. Microbiologic cultures identified Rhodococcus equi. A subsequent transbronchial biopsy and left pneumonectomy specimen confirmed the cytologic diagnosis.
  
  
  CONCLUSIONS
  Pulmonary malakoplakia associated with R equi pneumonia is a rare lesion that is essentially limited to immunocompromised hosts. Awareness of the FNA cytomorphology of this lesion permits resolution of the typical clinical differential diagnosis of pulmonary masses in the immunocompromised host and can facilitate treatment.
authors.affiliation: Division of Anatomic Pathology, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: C
authors.initials: C
authors.lastname: Lambert
authors.forename: T
authors.initials: T
authors.lastname: Gansler
authors.forename: K A
authors.initials: KA
authors.lastname: Mansour
authors.forename: S W
authors.initials: SW
authors.lastname: Schwartzmann
authors.forename: G M
authors.initials: GM
authors.lastname: Duffell
authors.forename: A A
authors.initials: AA
authors.lastname: Gal
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000473:pathology; D001707:Biopsy, Needle / Q000379:methods; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D008247:Lysosomes / Q000473:pathology / Q000648:ultrastructure; D016676:Macrophages, Alveolar / Q000473:pathology / Q000648:ultrastructure; D008287:Malacoplakia / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000648:ultrastructure; D014057:Tomography, X-Ray Computed