- Malakoplakia reasons
- Malakoplakia symptoms
- Differential diagnosis
- Treatment of a malakoplakia
Malakoplakia (malacoplakia; Greek malakos soft + plakion a plate) — the disease which is characterized by formation of whitish-yellow flat small knots to a bowl on a mucous membrane of uric ways, generative organs and is rare — intestines.
The bladder malakoplakia was described for the first time by D.Hansemann in 1903 B1965 of of J.Y.Temer and R.Latter reported about a malakoplakia of a large intestine. Frequency of damage of a bladder makes about 0,016% of all his diseases. The malakoplakia of a large intestine meets even less often and belongs to very rare diseases.
The etiology and pathogeny of a disease are unknown. Considering pathomorphologic features of a malakoplakia, it is impossible to exclude the disturbances of cellular immunity similar to those at Whipple's disease.
At macroscopic survey on a mucous membrane the polipovidny formations of yellowish color which are slightly acting over a surface are visible. At a histologic research it is visible that these educations consist of accumulations of the large macrophages having lines of lymphocytes, plasmocytes and fibroblasts (Hanzemann's histiocytes). At a histochemical research it is established that cells contain PAS positive substances. At the electronic and microscopic level it is established that the last represent if - and the klebsiyellopodobny bacilli concentrated in lizosomalny membranes of cells.
The clinical picture of a malakoplakia of a large intestine is characterized by a recurrence of diarrhea and decrease in body weight.
The diagnosis is established by means of a kolonoskopiya and a histologic research. At endoscopy reveal a mucosal atrophy and accumulations of numerous light yellow small knots and erosion in colonic and direct guts. At a histologic research find numerous stable macrophages in own plate of a mucous membrane and a submucosa. Stable macrophages contain typical cytoplasmic inclusions of a bacterial origin (Hanzemann's body) and Mikhaelis's little bodies — Guttman, the containing PAS positive structures characteristic of a malakoplakia.
The differential diagnosis should be carried out with xanthomas — the pathological educations arising in skin, some other fabrics including mucous membranes at disturbance of a lipometabolism. Xanthomas represent accumulations of the phagocytes containing cholesterol or triglycerides.
Treatment of a malakoplakia:
Medical tactics is not developed. Considering communication of pathomorphologic changes with microbic flora, a certain positive effect can be expected from antibacterial therapy.