Immunology/Microbiology for IDVaginal Malakoplakia Cancer Mimicking Infection—A Case Review and Review of LiteraturePatel, Deep B. BS∗; Maller, Bradley BS†; Abraham, Abel M. BS‡; Ramsakal, Asha DO‡; Hakam, Ardeshir MD§; Greene, John N. MD, FACP§Author Information From the ∗University of South Florida †University of South Florida Morsani College of Medicine ‡Department of Medicine §H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. Correspondence to: John N. Greene, MD, FACP, Infectious Diseases and Hospital Epidemiologist, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr, FOB-3, Tampa, FL 33612-9497. E-mail: [email protected]. The authors have no funding or conflicts of interest to disclose. Infectious Diseases in Clinical Practice: July 2021 - Volume 29 - Issue 4 - p e230-e235 doi: 10.1097/IPC.0000000000001034 Buy Metrics Abstract Malakoplakia is a rare chronic inflammatory disease that predominantly develops in the urogenital system. Although its clinical presentation can vary from asymptomatic to urgent depending on location, mass effect, and other factors, its gross appearance can be mistaken for malignancy. However, the histological identification of von Hansemann histiocytes and Michaelis-Gutmann bodies confirm the diagnosis of malakoplakia. We present a case of a female patient who sought medical care for acute pelvic discomfort attributed to urinary retention after urinary obstruction. Although the discovery of multiple masses within the vagina and pelvic cavity indicated a tumor, it was originally negative for malignancy. Histology of biopsy samples demonstrated Michaelis-Gutmann bodies mixed with lymphoid cells through immunohistochemical and periodic acid–Schiff stains, consistent with a diagnosis of malakoplakia. Despite negative cultures, multiple courses of antibiotics were given, but the mass progressed and caused urinary obstruction. After pelvic exenteration, lymphoma was diagnosed and treated. We review the current literature on malakoplakia in different body sites associated with infections and noninfectious diseases. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.