A Case of Rectal Malakoplakia in an Immunocompromised Woman With Chronic Colonic Bacterial Infections

Abstract

A 45-year-old woman with common variable immunodeficiency and interstitial lung disease on weekly intravenous immune globulin therapy and mycophenolate mofetil presents to the gastroenterology clinic following a year of worsening diarrhea. She reports 5 to 6 nonbloody bowel movements a day with 10-lb weight loss. On colonoscopy multiple 8- to 10-mm mucosal nodules were noted in the rectum (Figure A) surrounded by patchy areas of flattened carpet-like erythematous mucosal lesions (Figure B). Biopsies of the rectal nodules and mucosa are detailed at ×200 magnification pathology slides in Figures C and D through a hematoxylin-eosin and von Kossa stain, respectively.