Malacoplakia of the Endometrium, a Probable Cause of Postmenopausal Bleeding

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Abstract
Thomas, William, Jr., Sadeghieh, Bahram, Fresco, Raoul, Rubenstone, Albert I., Stepto, Robert C., and Carasso, Benjamin: Malacoplakia of the endometrium, a probable cause of post menopausal bleeding. Am J Clin Pathol 69: 637–641, 1978. A 60-year-old woman, 20 years postmenopausal, who had deforming rheumatoid arthritis of 7 years’ duration and Sjögren’s syndrome of 1 year’s duration, had had postmenopausal bleeding for a month prior to admission to the hospital. A diagnostic dilatation and curettage was interpreted as showing acute suppurative endometritis. The patient was discharged, only to have recurrent vaginal bleeding. She was readmitted five weeks later, at which time results of another dilatation and curettage were interpreted as showing xanthomatous endometritis. Total hysterectomy with bilateral salpingo-oophorectomy was done. Examination of Epon-embedded endometrium 1 µm thick by light microscopy and subsequently by electron microscopy disclosed intracellular bacilliform organisms within phagolysosomes of atypical histiocytes, lamellar bodies, and various developing stages of calcospherites, Michaelis-Gutmann bodies. The curettings were then received and classic MichaelisGutmann bodies were identified in periodic acid–Schiff-stained sections.

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