18-fluoro-deoxyglucose positron emission tomography may contribute to the diagnosis and follow-up of malakoplakia.

Malakoplakia is a rare inflammatory disease involving most frequently the urinary tract. We present a case of bilateral renal malakoplakia, in which FDG-PET contributed to diagnosis. We made this diagnosis on the basis of clinical presentation, renal biopsy showing a mixed cellular infiltrate with granuloma formation and possible Michaelis-Gutmann bodies, resolution of the lesions after prolonged antibiotic therapy and evidence of leukocyte dysfunction. We briefly discuss the pathophysiology and therapy of this rare and difficult to prove disease and the role of FDG-PET in the diagnosis of inflammatory and infectious diseases.