Malakoplakia of the small intestine as a cause of enterocutaneous fistula.

A case of malakoplakia of the small intestine presenting as an abscess of the anterior abdominal wall is described in a 28-year-old black Zimbabwean man. The patient developed an enterocutaneous fistula after incision and drainage of the abscess. Light and electronic microscopy revealed Michaelis-Gutmann bodies in some von Hansemann cells. He did well for eight months following laparotomy and resection of the fistula, but later died of a severe chest infection and septicaemia. It is suggested that malakoplakia in this case behaved like a locally aggressive lesion. Von Hansemann's histiocytes were sighted in the subcapsular sinus and germinal centres of nearby lymph nodes.