Question

A patient underwent cystoscopy, which showed multiple yellow-white plaques in the trigone of the bladder. The histopathology image is given below. What is the diagnosis?

• A. Interstitial cystitis
• B. Malakoplakia
• C. Polypoid cystitis
• D. Acute cystitis

Answer 1

The Correct Option is B

In the medical scenario described, a patient presents with multiple yellow-white plaques observed in the trigone of the bladder during a cystoscopic examination. To diagnose the condition, it's essential to correlate the clinical findings with typical histopathological features associated with bladder diseases.

Key Points to Consider:

• Yellow-white plaques: This visual characteristic is an important clue. In pathology, certain conditions may present with such coloration.
• Histopathology: Direct correlation with specific histological features is critical.

Diagnosis: Malakoplakia

Explanation:

• Malakoplakia is a rare inflammatory condition associated with impaired macrophage function leading to the accumulation of partially digested bacteria. It typically presents with soft, yellow-white plaques due to the accumulation of these macrophages in the affected area.
• Histological features: Presence of Michaelis-Gutmann bodies, which are concentrically layered calcium deposits seen within macrophages on histological examination, is pathognomonic for malakoplakia.
• Bladder involvement is commonly seen in malakoplakia, often presenting in the trigone region.

Based on the described plaques and their location, coupled with typical histological identifiers, malakoplakia is the most likely diagnosis.