Malakoplakia Presenting as a Mass in the Transplanted Kidney

Abstract Malakoplakia is a rare inflammatory condition that can affect many organ systems, including the genitourinary tract. It is associated with impaired immune function. Isolated renal parenchymal involvement has been reported in very few cases. Urinary tract and digestive malakoplakia have been reported in transplant recipients, but the involvement of transplant itself is rare. Variable clinical manifestations and nonspecific radiological appearance make the diagnosis difficult. The differential diagnosis includes infective etiologies and malignancy. We report a case of renal allograft malakoplakia, mimicking as a malignancy on 18 F-FDG PET/CT.