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Print ISSN: 2754-3242 Online ISSN: 2754-1304
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January-February 2026 Volume 6 Issue 1

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Case Report Open Access

Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature

  • Authors:
    • Rawa Bapir
    • Ismaeel Aghaways
    • Hadeel A. Yasseen
    • Ahmed H. Ahmed
    • Farman M. Faraj
    • Bryar Othman Muhammed
    • Twana Omer Saeed
    • Pavel W. Baqi
    • Marwan N. Hassan
    • Fahmi H. Kakamad

  • View Affiliations / Copyright

    Affiliations: Department of Scientific Affairs, Smart Health Tower, Sulaymaniyah 46001, Iraq, College of Medicine, University of Sulaimani, Sulaymaniyah 46001, Iraq, Smart Health Tower (Raparin Branch), Sulaymaniyah 46001, Iraq
    Copyright: © Bapir et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 8
    |
    Published online on: December 16, 2025
       https://doi.org/10.3892/mi.2025.292
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Abstract

Malakoplakia is a rare granulomatous inflammatory disease that primarily affects the genitourinary tract and is often associated with coliform infections. In rare cases, it can mimic tumors; however, to date, to the best of our knowledge, no case of malakoplakia due to Morganella morganii mimicking as a tumor has been reported. The present study describes the case of a patient with bladder malakoplakia caused by Morganella morganii, mimicking a bladder tumor. A 78‑year‑old male patient presented with complaints of dysuria, urinary frequency, urgency and incontinence. Upon a urinalysis, a marked number of pus cells were observed, and an abdominal ultrasound revealed bladder wall thickening. Flexible cystoscopy revealed a tight urethra and multiple sessile masses in the bladder. A urine culture revealed infection with Morganella morganii, and the patient was treated with antibiotics.  Following transurethral resection of the masses, histopathological analysis revealed von Hansemann cells and Michaelis‑Gutmann bodies, confirming the diagnosis of malakoplakia. Immunohistochemistry was negative for AE1/AE3 and S100, but positive for CD68. In addition, 10 cases in the literature were reviewed; all patients in these cases were elderly or adults, apart from one case. Of note, 6 cases had Escherichia coli infection, and 1 case also had Pseudomonas aeruginosa infection. A total of 6 cases underwent mass resection, while 4 cases were managed conservatively; one of these experienced recurrence. On the whole, the present study demonstrates that bladder malakoplakia can also arise from infection with Morganella morganii and mimic a tumor; thus, it should be considered in the differential diagnosis of bladder inflammation or masses.
View Figures

Figure 1

Cystoscopy images (all three images) illustrating multiple, diffuse, irregular and sessile masses throughout the bladder.

Figure 2

(A) Subepithelial mucosal infiltrate composed of sheets of polygonal cells with granular eosinophilic cytoplasm (magnification, x40). (B) Some polygonal cells display basophilic intracytoplasmic inclusions (arrows); hematoxylin and eosin staining (magnification, x100).

Figure 3

(A) Periodic acid-Schiff staining highlighting the intracytoplasmic inclusions (arrows) (magnification, x100). (B) Periodic acid-Schiff with diastase staining demonstrating the presence of Michaelis-Gutmann bodies (arrows) (magnification, x100). (C) Prussian blue staining illustrating the Michaelis-Gutmann bodies (arrows) (magnification, x100).

Figure 4

(A) Mucosal polygonal cells are negative for AE1/AE3, effectively excluding an epithelial origin (magnification, x40). (B) Strong, diffuse cytoplasmic positivity for CD68 supports a histiocytic lineage (magnification, x40).
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Copy and paste a formatted citation
Spandidos Publications style
Bapir R, Aghaways I, Yasseen HA, Ahmed AH, Faraj FM, Muhammed BO, Saeed TO, Baqi PW, Hassan MN, Kakamad FH, Kakamad FH, et al: Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature. Med Int 6: 8, 2026.
APA
Bapir, R., Aghaways, I., Yasseen, H.A., Ahmed, A.H., Faraj, F.M., Muhammed, B.O. ... Kakamad, F.H. (2026). Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature. Medicine International, 6, 8. https://doi.org/10.3892/mi.2025.292
MLA
Bapir, R., Aghaways, I., Yasseen, H. A., Ahmed, A. H., Faraj, F. M., Muhammed, B. O., Saeed, T. O., Baqi, P. W., Hassan, M. N., Kakamad, F. H."Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature". Medicine International 6.1 (2026): 8.
Chicago
Bapir, R., Aghaways, I., Yasseen, H. A., Ahmed, A. H., Faraj, F. M., Muhammed, B. O., Saeed, T. O., Baqi, P. W., Hassan, M. N., Kakamad, F. H."Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature". Medicine International 6, no. 1 (2026): 8. https://doi.org/10.3892/mi.2025.292
Copy and paste a formatted citation
x
Spandidos Publications style
Bapir R, Aghaways I, Yasseen HA, Ahmed AH, Faraj FM, Muhammed BO, Saeed TO, Baqi PW, Hassan MN, Kakamad FH, Kakamad FH, et al: Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature. Med Int 6: 8, 2026.
APA
Bapir, R., Aghaways, I., Yasseen, H.A., Ahmed, A.H., Faraj, F.M., Muhammed, B.O. ... Kakamad, F.H. (2026). Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature. Medicine International, 6, 8. https://doi.org/10.3892/mi.2025.292
MLA
Bapir, R., Aghaways, I., Yasseen, H. A., Ahmed, A. H., Faraj, F. M., Muhammed, B. O., Saeed, T. O., Baqi, P. W., Hassan, M. N., Kakamad, F. H."Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature". Medicine International 6.1 (2026): 8.
Chicago
Bapir, R., Aghaways, I., Yasseen, H. A., Ahmed, A. H., Faraj, F. M., Muhammed, B. O., Saeed, T. O., Baqi, P. W., Hassan, M. N., Kakamad, F. H."Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature". Medicine International 6, no. 1 (2026): 8. https://doi.org/10.3892/mi.2025.292
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