18-fluoro-deoxyglucose positron emission tomography may contribute to the diagnosis and follow-up of malakoplakia.
Malakoplakia is a rare inflammatory disease involving most frequently the urinary tract. We present a case of bilateral renal malakoplakia, in which FDG-PET contributed to diagnosis. We made this diagnosis on the basis of clinical presentation, renal biopsy showing a mixed cellular infiltrate with granuloma formation and possible Michaelis-Gutmann bodies, resolution of the lesions after prolonged antibiotic therapy and evidence of leukocyte dysfunction. We briefly discuss the pathophysiology and therapy of this rare and difficult to prove disease and the role of FDG-PET in the diagnosis of inflammatory and infectious diseases.
Department of General Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium. peter.vanbrabant@uz.kuleuven.ac.be
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Vanbrabant
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Drieskens
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Blockmans
D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008287:Malacoplakia / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D000892:Anti-Infective Agents, Urinary; D000975:Antioxidants; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D001205:Ascorbic Acid