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Malacoplakia presenting with obstructive nephropathy with bilateral ureter involvement

Nature Reviews Nephrology volume 5, pages 418–422 (2009)Cite this article

Abstract

Background. A 48-year-old woman with chronic urinary tract infections presented with uremia. Imaging studies revealed bilateral hydronephrosis and segmental ureteral thickening.

Investigations. Physical examination, urine and blood analysis, radiography of the chest, chest CT, abdominal and pelvis CT, renal ultrasonography, cystoscopy, anterograde pyelogram, bladder biopsy.

Diagnosis. Malacoplakia involving bilatateral ureters and bladder; cavitary pneumonia.

Management. Hemodialysis, placement of bilateral percutaneous nephrostomy tubes, administration of ciprofloxacin, ascorbic acid and bethanechol.

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Figure 1: Non-contrast CT scans of the abdomen.
Figure 2: Dynamic X-ray images of the anterograde pyelogram of bilateral ureters.
Figure 3: Photographs of samples obtained from the bladder biopsy specimen.
Figure 4: Photograph of a bladder biopsy specimen processed with Von Kossa's stain test reagents.

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Acknowledgements

The authors would like to thank Jeff Sands MD and Arlene Chapman MD for reviewing the manuscript, and Christine Norton MD for assisting with pathology slides and legends.

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Authors and Affiliations

  1. Emory University School of Medicine, Atlanta, GA, USA

    Lorin M. Sanchez, Sean I. Sanchez & James L. Bailey

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  1. Lorin M. Sanchez
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Correspondence to Sean I. Sanchez.

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Sanchez, L., Sanchez, S. & Bailey, J. Malacoplakia presenting with obstructive nephropathy with bilateral ureter involvement. Nat Rev Nephrol 5, 418–422 (2009). https://doi.org/10.1038/nrneph.2009.86

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