| Abstrakt: |
Malakoplakia is an unusual pathological finding produced by chronic inflammation. It was first described in the urinary bladder (Michaelis & Gutmann, 1902) and since then over 200 cases have been reported. The urinary bladder is the most common site, and the prostate, testis, ureter, renal pelvis and kidney are occasionally affected. Organs outside the genito-urinary system are only seldom involved (Sinclair-Smith et al, 1975). Only 35 cases of renal parenchymal malakoplakia have been reported and only a few of these with radiological or ultrasound images (Hartman et al, 1980). We wish to report two new cases with radiological images and ultrasound images of one.A 53-year-old woman, with a history of rheumatoid arthritis for 17 years, was receiving cortisone therapy. She was admitted to hospital because of fever, right upper abdominal pain and a high sedimentation rate. She had a history of several urinary tract infections that had been treated medically. On examination the patient had a Cushinoid habitus and severely deformed joints due to rheumatoid arthritis. She was febrile and slightly hypertensive, and had local tenderness in the right upper abdominal quadrant. The haemoglobin was 85 g/1, the white cell count 14.4 × 109/1, the sedimentation rate 127, and a reactive thrombocytosis of 779 × 109/1 was noted. The blood creatinine level was normal. There was pyuria and E. coliwas cultured from the urine.Ultrasound examination revealed a mass in the caudal part of the kidney (Fig. 1a). |
