Amaravati, a 51 year old cancer patient under chemotherapy, presented with clinical features of urinary tract infection. Fever with rigors and pain in the flank are present. Urine examination shows protein in variable amounts, leukocytes and few RBCs. Culture shows presence of E.coli. Bladder wash shows characteristic polygonal granular cells and Michaelis gutmann bodies. Which one of the following condition is associated with the features?
Malakoplakia is an uncommon inflammatory disorder of unknown etiology, it is identified by the accumulation of characteristic macrophages. It is characterized by soft, yellow plaques on the mucosal surface of the bladder. Histologically, the most striking feature is a chronic inflammatory cell infiltrate composed predominantly of large macrophages with abundant, eosinophilic cytoplasm containing periodic acid-Schiff (PAS)-positive granules. Some of these macrophages exhibited, laminated basophilic calcospherites, termed Michaelis-Gutmann bodies. Ultrastructurally, these granules are engorged lysosomes that contain fragments of bacteria. The Michaelis-Gutmann bodies result from calcium salt deposition in these enlarged lysosomes. Malakoplakia is often associated with urinary tract infection by E.coli. A clinical background of immunosuppression, chronic infections, or cancer is common. Ref: Heptinstall's Pathology of the Kidney: Editors, J. Charles Jennette, Jean L ... By J. Charles Jennette, Robe H. Heptinstall, 2007, Volume 1, Page 1008 ; Rubin's Pathology: Clinicopathologic Foundations of Medicine By Raphael Rubin, M.D., David Sheldon Strayer, Page 816
Malakoplakia
Xanthogranulomatous pyelonephritis
Nail patella syndrome
Xanthelesma