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Currently filtering by tag: Michaelis-Gutmann body

Where is the normal kidney tissue?

This kidney biopsy shows the histologic features characteristic of malakoplakia, which includes a dense, often obliterative, inflammatory infiltrate rich in histiocytes (Fig. 1 and 2) with numerous small intracytoplasmic concretions known as Michaelis-Gutmann bodies (these are best identified using histochemical staining for calcium as in Fig. 3). Malakoplakia is thought to result from chronic bacterial infection of the urinary tract (the most common causative organism is E. coli). Many cases are associated with the formation of small plaques and/or mass lesions. The bladder is the most common site of involvement, but kidney involvement occurs in about 15% of cases. The...

Diagnose This! (October 9, 2017)

What is your diagnosis?     ​   ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​   ​   ​...

Malakoplakia

An adult patient in the mid-fifties with a deceased donor renal transplant for three years (primary disease “hypertensive nephrosclerosis”) presented with a low-grade fever and a rising creatinine. Urinalysis showed hematuria and proteinuria. A transplant biopsy was performed. 1. Low power showing one relatively intact core and a second core showing diffuse replacement of the usual renal parenchyma by inflammation and fibrosis (Trichrome, 40x) 2. Mixed inflammatory cell infiltrate (Jones Silver, 400x) 3. Macrophages with PAS-positive granules (PAS, 400x) 4. Michaelis-Gutmann body (H&E, 400x 5. Michaelis-Gutmann body (H&E, original magnification 600x) 6. Von Kossa Positive Michaelis-Gutmann bodies (von Kossa, 400x)...