Case ReportRadiographic and Endoscopic Features of Pancreaticoduodenal MalakoplakiaHubbard, Lauren BS*; Iriana, Sentia MD, MS†; Carey, Adrienne MD‡; Odrobina, Robert MD‡; Sossenheimer, Michael MD, PhD†; Rogers, Douglas MD§Author Information From the *University of Utah School of Medicine Divisions of †Gastroenterology ‡Infectious Disease §Department of Radiology and Imaging Sciences, University of Utah Medical Center, Salt Lake City, UT. Received for publication September 25, 2019; accepted January 14, 2020. Address correspondence to: Douglas Rogers, MD, Department of Radiology, University of Utah School of Medicine, 50 N Medical Dr, Salt Lake City, UT 84132 (e-mail: Douglas.email@example.com). The authors declare no conflict of interest and financial support. Pancreas: March 2020 - Volume 49 - Issue 3 - p 455-460 doi: 10.1097/MPA.0000000000001497 Buy Metrics Abstract Malakoplakia is a rare, granulomatous disorder that is typically triggered by infections in immunocompromised patients. Although it most commonly affects the urinary tract, cases may occasionally occur in the gastrointestinal tract. There are case reports of malakoplakia of the pancreas with associated pathologic description, but none with detailed imaging and endoscopic findings. In addition, description of magnetic resonance imaging characteristics of mass-forming malakoplakia in the literature is sparse. We present a case of pancreaticoduodenal malakoplakia in an immunocompromised patient, including detailed description of magnetic resonance imaging, computed tomography, and endoscopic findings with radiology-pathology correlation. Classic pathologic features of malakoplakia (eg, hypercellularity, inflammation, and mineralization of Michaelis-Gutmann bodies) lead to specific features on imaging, such as marked diffusion restriction, heterogeneous enhancement, calcification, and increased attenuation on nonenhanced computed tomography. These features may help differentiate malakoplakia from other more common lesions that occur in this location, especially if present in an immunocompromised patient. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.