Question

Michaelis-Gutmann bodies are seen in which condition?

• A. Xanthogranulomatous pyelonephritis
• B. Pyelonephritis
• C. Malakoplakia
• D. Nail patella syndrome

Hint:

Laminated calcified bodies in defective bladder macrophages point to which lesion?

Answer 1

The Correct Option is C

Step 1: Michaelis-Gutmann bodies are the diagnostic hallmark of malakoplakia. Malakoplakia is an unusual chronic inflammatory reaction, most often of the bladder (a variant of cystitis), linked to chronic bacterial infection, typically by E. coli or sometimes Proteus.

Step 2: It arises from a defect in the phagocytic or degradative function of macrophages. Grossly it forms soft yellow slightly raised mucosal plaques. Microscopically there are large foamy macrophages (von Hansemann cells) with PAS-positive granular cytoplasm, plus giant cells and lymphocytes.

Step 3: Within and between these macrophages lie Michaelis-Gutmann bodies, which are laminated mineralized concretions formed by calcium deposition in enlarged lysosomes. They are PAS positive and diastase resistant, and stain positive with von Kossa (for calcium) and Perls Prussian blue (for iron).

Step 4: The other options do not show these bodies, so malakoplakia is the answer.