Malakoplakia in sclera of the left eye- A rare case report

Abstract

“Malakoplakia” comes from Greek words malakos (soft) and plakos (plaque). It is a rare histiocytic disease that may occur in all organs, most frequently involving GU tract, particularly bladder. Other organs involved are gastrointestinal tract (most commonly colon, followed by stomach and duodenum), central nervous system and female genital tract. Malignancy and other forms of immunosuppression are predisposing factors. Malakoplakia in eye and orbit region are extremely rare and are usually appraised by the pathologist on histopathology sections with a few mimickers as differential diagnosis. Histopathological features showed. Collections of histiocytes with granular eosinophilic cytoplasm accumulated beneath the surface epithelium. Few cells showed round, concentrically layered intracytoplasmic inclusions known as Michaelis–Gutmann (MG) bodies which are characteristic of malakoplakia. The MG bodies are basophilic and are demonstrated by Periodic Acid–Schiff (PAS) stain and stains for iron and calcium. Rare histiocytic disease that can simulate a neoplasm. Gross appearance: Single or multiple white-yellow soft raised plaques on the mucosal surface. Pathological diagnosis/entity rather than a clinical impression and warrants special stains to arrive at the histological conclusion.More common in immunocompromised (HIV, renal transplant recipients) and women Noted in > 50 years of age Malakoplakia is presently regarded as a defect in the host macrophage (phagolysosomal) response to a bacterial infection, usually from gram-negative coliformbacilli. Malakoplakia should be kept as one of the differential diagnosis by the pathologist when dealing with ophthalmic specimen.