A67 CASE REPORT: A RARE CASE OF MALAKOPLAKIA
Bibliographic record
Abstract
Abstract Background Malakoplakia is a rare chronic granulomatous inflammatory condition first described in the literature in 19021. It is thought to be a result of impaired macrophages ability to completely digest and kill bacteria, resulting in phagocytosed bacteria accumulating in macrophages calcifying overtime. Malakoplakia can affect all organs of the body and is four-times more likely to affect females2. It most commonly occurs within the genitourinary tract with the gastrointestinal tract being the second most common site. Aims The literature regarding malakoplakia of the rectum is limited and rare3. Methods This 39-year-old immunosuppressed male with a history of three renal transplants receiving tacrolimus and chronic prednisone found to have rectal malakoplakia. He was referred to gastroenterology for symptoms of constipation and iron deficiency anemia. A colonoscopy was completed which demonstrated 4-rectal polyps, each at an estimated size of 5 mm which were removed by cold snare. Results The rectal polyps were sent for histological analysis and demonstrated expansion of cells into the lamina propria. Cells were mostly epithelioid histiocytes with some admixed neutrophils, lymphocytes, and plasma cells, but infiltration did not destroy the mucosal architecture or crypts. Some of the histiocytes contain pale, round intracytoplasmic structures with concentric layering, consistent with Michaelis-Gutmann bodies. CD68 confirmed infiltrating cells were macrophages, confirming a diagnosis of rectal malakoplakia (Figure 1). Conclusions He was seen in follow-up in Gastroenterology clinic and his symptoms of constipation, did not appear to be contributory towards this incidental finding of malakoplakia. Furthermore, infectious disease was involved in this patient’s care for consideration of antimicrobial therapy, but a decision was made to treat conservatively and monitor for any new gastrointestinal symptoms. This patient is followed by gastroenterology and booked for repeat colonoscopy in 6-months for follow-up to determine if these lesions can be eradicated through polypectomy. 1. Liu, Xiangyu, et al. “Rectal malakoplakia mimicking advanced rectal cancer: A case report.” Heliyon 9.10 (2023). 2. Wang, Zhenting, and Jiannan Ren. “Clinical analysis of renal failure caused by malakoplakia: a case report and literature review.” Frontiers in Medicine 9 (2022): 770731. 3. Achufusi, T. G., Jessamy, K., Chebaya, P., & Rawlins, S. (2020). Rectal malakoplakia. Proceedings (Baylor University. Medical Center), 33(3), 389–390. Funding Agencies:
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.011 | 0.005 |
| Insufficient payload (model declined to judge) | 0.008 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".