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Clinical Problem Solving: Pathology
October 2006

Pathology Quiz Case 2: Diagnosis

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Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Otolaryngol Head Neck Surg. 2006;132(10):1159. doi:10.1001/archotol.132.10.1159

Malakoplakia (from the Greek words malakos, meaning soft, and plakos, meaning plaque), which was first described in 1902,1 is a rare condition that is difficult to diagnose because it presents with nonspecific findings. It is a distinct variant of chronic inflammation with characteristic histopathologic features. Seventy-five percent of cases occur in the urogenital tract. Although malakoplakia can occur at any age, the peak incidence occurs in the fifth to seventh decades of life and develops more frequently in women than in men (although whether this applies to malakoplakia outside the urogenital system is unclear). The next most common sites of occurrence are the colon, lungs, and bone. Malakoplakia in the head and neck region is relatively rare; a review of the literature revealed 4 cases in the larynx, 3 in the tongue, 3 in the tonsil, 3 in the thyroid gland, 2 in the nasopharynx, 2 in the middle ear, 2 in cervical soft tissue, 1 in the parotid gland, 1 in the maxillary antrum, and 1 in the trachea.2,3

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