{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:37:16Z","timestamp":1787031436171,"version":"build-2736575974"},"reference-count":35,"publisher":"Societatea Romana de Morfologie","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rom J Morphol Embryol"],"published-print":{"date-parts":[[2025,8,27]]},"abstract":"<jats:p>Background\/Objectives: Malakoplakia is an uncommon clinicopathological entity defined by the accumulation of dysfunctional macrophages containing undigested bacterial remnants and pathognomonic Michaelis\u2013Gutmann bodies. Although it most frequently involves the gastrointestinal tract, particularly the colon, rectum, and rectosigmoid junction, appendiceal involvement remains rare. This case represents only the fourth reported occurrence of appendiceal malakoplakia in a young, immunocompetent adult without notable comorbidities, underscoring its exceptional clinical presentation. Study selection for review: A PubMed search was performed to explore the current understanding of malakoplakia, with emphasis on its etiopathogenesis, diagnostic criteria, and therapeutic strategies. Case presentation: A 25-year-old immunocompetent male presented with a periappendicular abscess mimicking a tumor, ultimately requiring right hemicolectomy. Histopathological (HP) evaluation confirmed intestinal-appendicular malakoplakia and granulomatous lymphadenitis, with no evidence of tuberculosis, underscoring the diagnostic challenge and the need for further investigation into its etiopathogenesis in young, otherwise healthy individuals. Conclusions: This case illustrates a rare instance of appendicular malakoplakia in a young adult, emphasizing the importance of HP evaluation for accurate diagnosis and the need to consider this entity in the differential diagnosis of appendiceal masses to avoid mismanagement.<\/jats:p>","DOI":"10.47162\/rjme.66.2.04","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:31:18Z","timestamp":1756729878000},"page":"313-321","source":"Crossref","is-referenced-by-count":4,"title":["Appendiceal malakoplakia: a review of the literature and case presentation"],"prefix":"10.47162","volume":"66","author":[{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Railway Clinical Hospital, Craiova, Romania","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren\u0163iu Augustus","family":"Barbu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liviu","family":"Vasile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Florin R\u0103zvan","family":"Mogo\u015f","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Railway Clinical Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeriu","family":"\u015eurlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ionic\u0103 Daniel","family":"V\u00eelcea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Cercelaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Anatomy, University of Medicine and Pharmacy of Craiova, Romania; Department of Pathology, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stelian \u015etef\u0103ni\u0163\u0103","family":"Mogoant\u0103","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolae-Drago\u015f","family":"M\u0103rg\u0103ritescu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Emergency County Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiberiu \u015etef\u0103ni\u0163\u0103","family":"\u0162enea-Cojan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Department of Surgery, University of Medicine and Pharmacy of Craiova, Romania; Department of Surgery, Railway Clinical Hospital, Craiova, Romania","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"26736","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"\"[1] Lee M, Ko HM, Rubino A, Lee H, Gill R, Lagana SM. Malakoplakia of the gastrointestinal tract: clinicopathologic analysis of 23 cases. Diagn Pathol, 2020, 15(1):97. https:\/\/doi.org\/10.1186\/s13000-020-01013-y","DOI":"10.1186\/s13000-020-01013-y"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"[2] Yousef GM, Naghibi B, Hamodat MM. Malakoplakia outside the urinary tract. Arch Pathol Lab Med, 2007, 131(2):297-300. https:\/\/doi.org\/10.5858\/2007-131-297-MOTUT","DOI":"10.5858\/2007-131-297-MOTUT"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"[3] Abdou NI, NaPombejara C, Sagawa A, Ragland C, Stechschulte DJ, Nilsson U, Gourley W, Watanabe I, Lindsey NJ, Allen MS. Malakoplakia: evidence for monocyte lysosomal abnormality correctable by cholinergic agonist in vitro and in vivo. N Engl J Med, 1977, 297(26):1413-1419. https:\/\/doi.org\/10.1056\/NEJM197712292972601","DOI":"10.1056\/NEJM197712292972601"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"[4] Blackshear WM Jr. Malakoplakia of the appendix: a case report. Am J Clin Pathol, 1970, 53(2):284-287. https:\/\/doi.org\/10.1093\/ajcp\/53.2.284","DOI":"10.1093\/ajcp\/53.2.284"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"[5] van Crevel R, Curfs J, van der Ven AJ, Assmann K, Meis JF, van der Meer JW. Functional and morphological monocyte abnormalities in a patient with malakoplakia. Am J Med, 1998, 105(1):74-77. https:\/\/doi.org\/10.1016\/s0002-9343(98)00130-2","DOI":"10.1016\/S0002-9343(98)00130-2"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"[6] Dasgupta P, Womack C, Turner AG, Blackford HN. Malacoplakia: von Hansemann's disease. BJU Int, 1999, 84(4):464-469. https:\/\/doi.org\/10.1046\/j.1464-410x.1999.00198.x","DOI":"10.1046\/j.1464-410x.1999.00198.x"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"[7] Kradin RL, Sheldon TA, Nielsen P, Selig M, Hunt J. Malacoplakia of the tongue complicating the site of irradiation for squamous cell carcinoma with review of the literature. Ann Diagn Pathol, 2012, 16(3):214-218. https:\/\/doi.org\/10.1016\/j.anndiagpath.2011.02.001","DOI":"10.1016\/j.anndiagpath.2011.02.001"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"[8] Masters EA, Ricciardi BF, Bentley KLM, Moriarty TF, Schwarz EM, Muthukrishnan G. Skeletal infections: microbial pathogenesis, immunity and clinical management. Nat Rev Microbiol, 2022, 20(7):385-400. https:\/\/doi.org\/10.1038\/s41579-022-00686-0","DOI":"10.1038\/s41579-022-00686-0"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"[9] \u015eerban C, Toma A, Voicu DC, Popazu C, Firescu D, \u0162ocu G, Mihailov R, Rebegea L. A surgical challenge generated by colonic malakoplakia in disguise as a locally advanced colonic malignancy - a case report. Medicina (Kaunas), 2023, 59(1):156. https:\/\/doi.org\/10.3390\/medicina59010156","DOI":"10.3390\/medicina59010156"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"[10] Govender D, Essa AS. Malakoplakia and tuberculosis. Pathology, 1999, 31(3):280-283. https:\/\/doi.org\/10.1080\/003130299105160","DOI":"10.1080\/003130299105160"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"[11] Brownstein PK, Mannes H, Bogaev JH. Sarcoidosis and malakoplakia. Urology, 1975, 6(2):249-251. https:\/\/doi.org\/10.1016\/0090-4295(75)90727-x","DOI":"10.1016\/0090-4295(75)90727-X"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"[12] Jain M, Arora VK, Singh N, Bhatia A. Malakoplakia of the appendix. An unusual association with eggs of Taenia species. Arch Pathol Lab Med, 2000, 124(12):1828-1829. https:\/\/doi.org\/10.5858\/2000-124-1828-MOTA","DOI":"10.5858\/2000-124-1828-MOTA"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"[13] Pastena D, Giambusso M, Castri F, Potenza AE, Caprino P, Sacchetti F, Sofo L. Malakoplakia of the appendix in a young healthy adult: a case report and literature review. J Surg Case Rep, 2022, 2022(8):rjac357. https:\/\/doi.org\/10.1093\/jscr\/rjac357","DOI":"10.1093\/jscr\/rjac357"},{"issue":"4","key":"ref13","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1097\/00000478-197812000-00004","article-title":"Two unusual cases which presented diagnostic problems","volume":"2","author":"TV. Malakoplakia","year":"1978","unstructured":"[14] Colby TV. Malakoplakia. Two unusual cases which presented diagnostic problems. Am J Surg Pathol, 1978, 2(4):377-382.","journal-title":"Am J Surg Pathol"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"[15] McClure J. Malakoplakia of the gastrointestinal tract. Postgrad Med J, 1981, 57(664):95-103. https:\/\/doi.org\/10.1136\/pgmj.57.664.95","DOI":"10.1136\/pgmj.57.664.95"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"[16] Zhang Y, Byrnes K, Lam-Himlin D, Pittman M, Pezhouh M, Gonzalez RS, Alruwaii Z, Larman T, Miller JA, Matoso A, Oshima K, Epstein JI, Montgomery EA, Voltaggio L. Gastrointestinal malakoplakia: clinicopathologic analysis of 26 cases. Am J Surg Pathol, 2020, 44(9):1251-1258. https:\/\/doi.org\/10.1097\/PAS.0000000000001491","DOI":"10.1097\/PAS.0000000000001491"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"[17] Barbu LA, M\u0103rg\u0103ritescu ND, Cercelaru L, Caragea DC, V\u00eelcea ID, \u015eurlin V, Mogoant\u0103 S\u015e, Mogo\u015f GFR, Vasile L, \u0162enea Cojan T\u015e. Can thrombosed abdominal aortic dissecting aneurysm cause mesenteric artery thrombosis and ischemic colitis? - A case report and a review of literature. J Clin Med, 2025, 14(9):3092. https:\/\/doi.org\/10.3390\/jcm14093092","DOI":"10.3390\/jcm14093092"},{"key":"ref17","unstructured":"[18] Pandit SP, Shetty SP, Shah KA, Deodhar KP. Malacoplakia of the appendix. Indian J Gastroenterol, 1989, 8(4):304-305."},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"[19] Borghesi MR, Cogolo L, Mazzarello PL, Romanelli R. Malakoplakia of the appendix. Minerva Chir, 1997, 52(4):465-467.","DOI":"10.3917\/popu.p1997.52n2.0467"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"[20] Shaktawat SS, Sissons MCJ. Malakoplakia of the appendix, an uncommon entity at an unusual site: a case report. J Med Case Rep, 2008, 2:181. https:\/\/doi.org\/10.1186\/1752-1947-2-181","DOI":"10.1186\/1752-1947-2-181"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"[21] Edmund L, Mohammed W. Colonic carcinoma associated with malakoplakia. West Indian Med J, 2014, 63(6):664-666. https:\/\/doi.org\/10.7727\/wimj.2014.079","DOI":"10.7727\/wimj.2014.079"},{"key":"ref21","unstructured":"[22] Barbu LA, M\u0103rg\u0103ritescu ND, Ghilu\u015fi MC, Belivac\u0103 D, Georgescu EF, Ghelase \u015eM, Marinescu D. Severe upper gastrointestinal bleeding from gastrointestinal stromal tumor of the stomach. Rom J Morphol Embryol, 2016, 57(4):1397-1401."},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"[23] Flint A, Murad TM. Malakoplakia and malakoplakialike lesions of the upper gastrointestinal tract. Ultrastruct Pathol, 1984, 7(2-3):167-176. https:\/\/doi.org\/10.3109\/01913128409141474","DOI":"10.3109\/01913128409141474"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"[24] Barbu LA, Vasile L, \u0162enea-Cojan T\u015e, Mogo\u015f GFR, \u015eurlin V, V\u00eelcea ID, Cercelaru L, Mogoant\u0103 S\u015e, M\u0103rg\u0103ritescu ND. Endometrioid adenofibroma of ovary - a literature review. Rom J Morphol Embryol, 2025, 66(1):39-49. https:\/\/doi.org\/10.47162\/RJME.66.1.03","DOI":"10.47162\/RJME.66.1.03"},{"key":"ref24","unstructured":"[25] M\u0103rg\u0103ritescu ND, Ciobanu MO, Neme\u015f RN, Ghelase \u015eM, Ple\u015fea RM, Georgescu I, Voinea B, Ple\u015fea IE, Chiu\u0163u LC. The morphological profile of small bowel tumors - our experience. Rom J Morphol Embryol, 2016, 57(4):1241-1252."},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"[26] Berney T, Chautems R, Ciccarelli O, Latinne D, Pirson Y, Squifflet JP. Malakoplakia of the caecum in a kidney-transplant recipient: presentation as acute tumoral perforation and fatal outcome. Transpl Int, 1999, 12(4):293-296. https:\/\/doi.org\/10.1007\/s001470050227","DOI":"10.1007\/s001470050227"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"[27] Jeong JW, Noh JH, Kang JH, Park JH, Lee JH. Cecal malakoplakia: a case report. Korean J Clin Oncol, 2021, 17(1):44-47. https:\/\/doi.org\/10.14216\/kjco.21007","DOI":"10.14216\/kjco.21007"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"[28] Rizzo E, Sandmeier D, Hack I, Matter M, Bouzourene H. Malakoplakia and colonic adenoma: a rare association. Ann Diagn Pathol, 2004, 8(6):364-366. https:\/\/doi.org\/10.1053\/j.anndiagpath.2004.08.007","DOI":"10.1053\/j.anndiagpath.2004.08.007"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"[29] Divya P, Crasta JA. Pediatric malakoplakia of colon: a report of two cases. Pediatr Surg Int, 2010, 26(3):323-325. https:\/\/doi.org\/10.1007\/s00383-010-2551-3","DOI":"10.1007\/s00383-010-2551-3"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"[30] Pillay K, Chetty R. Malakoplakia in association with colorectal carcinoma: a series of four cases. Pathology, 2002, 34(4):332-335. https:\/\/doi.org\/10.1080\/003130202760120481","DOI":"10.1080\/003130202760120481"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"[31] En\u0103tescu VR, Kalinovi\u0107 R, Vlad G, Nussbaum LA, Hogea L, En\u0103tescu I, Marinescu I, Ifteni P, Simu M, Marian C, Giurgi-Oncu C, Papav\u0103 I. The presence of peripheral inflammatory markers in patients with major depressive disorder, the associated symptoms profiles and the antidepressant efficacity of Celecobix. Farmacia, 2020, 68(3):483-491. https:\/\/doi.org\/10.31925\/farmacia.2020.3.14","DOI":"10.31925\/farmacia.2020.3.14"},{"key":"ref31","unstructured":"[32] Bondoc EN, Marinescu D, Marinescu I, M\u0103lin RD, Stanca L, Z\u0103voi RE. Current understanding of psycho-neurobiology in depressive disorders with suicidal thoughts - translational models. Rom J Morphol Embryol, 2019, 60(2):389-402."},{"key":"ref32","unstructured":"[33] Marinescu I, En\u0103tescu VR, Ghelase \u015eM, Marinescu D, Neurobiological arguments for a pathogenic multifactorial disconnective model of cognitive disorders from Alzheimer's disease in elderly people. Rom J Morphol Embryol, 2017, 58(4):1165-1173."},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"[34] Stovicek PO, Friedmann C, Marinescu D, V\u0103duva IA, Bondari S, Trifu SC, Marinescu I. Mild TBI in the elderly - risk factor for rapid cognitive impairment in Alzheimer's disease. Rom J Morphol Embryol, 2020, 61(1):61-72. https:\/\/doi.org\/10.47162\/rjme.61.1.07","DOI":"10.47162\/RJME.61.1.07"},{"key":"ref34","unstructured":"[35] Dehelean L, Marinescu I, Stovicek PO, Andor M. Cardiovascular anomalies and evolutionary risk factors in schizophrenia - multifactorial approach. Rom J Morphol Embryol, 2019, 60(4):1105-1113.\""}],"container-title":["Romanian Journal of Morphology and Embryology"],"original-title":[],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:41:55Z","timestamp":1756730515000},"score":1,"resource":{"primary":{"URL":"https:\/\/rjme.ro\/archive\/66\/2\/4\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,8,27]]}},"URL":"https:\/\/doi.org\/10.47162\/rjme.66.2.04","relation":{},"ISSN":["1220-0522","2066-8279"],"issn-type":[{"value":"1220-0522","type":"print"},{"value":"2066-8279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}