Xanthogranulomatous inflammation of the perimetrium with infiltration into the uterine myometrium in a postmenopausal woman: a case report

详细信息    查看全文

• 作者：Tomoko Inoue (4)
  Katsutoshi Oda (4)
  Takahide Arimoto (4)
  Taiki Samejima (4)
  Yutaka Takazawa (5)
  Daichi Maeda (5)
  Masashi Fukayama (5)
  Kei Kawana (4)
  Yutaka Osuga (4)
  Tomoyuki Fujii (4)
  
  4. Department of Obstetrics and Gynecology ; Faculty of Medicine ; The University of Tokyo ; 7-3-1 Hongo ; Bunkyo-ku ; Tokyo ; 113-8655 ; Japan
  5. Department of Pathology ; The University of Tokyo ; 7-3-1 Hongo ; Bunkyo-ku ; Tokyo ; 113-8655 ; Japan
  
• 关键词：Xanthogranulomatous inflammation ; Myometrial infiltration ; Perimetritis
• 刊名：BMC Women's Health
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：1,293 KB
• 参考文献：1. Guzman-Valdivia, G (2004) Xanthogranulomatous cholecystitis: 15years鈥?experience. World J Surg 28: pp. 254-257 CrossRef
  2. Korkes, F, Favoretto, RL, Broglio, M, Silva, CA, Castro, MG, Perez, MD (2008) Xanthogranulomatous pyelonephritis: clinical experience with 41 cases. Urology 71: pp. 178-180 CrossRef
  3. Russack, V, Lammers, RJ (1990) Xanthogranulomatous endometritis: Report of six cases and a proposed mechanism of development. Arch Pathol Lab Med 114: pp. 929-932
  4. Chechia, A, Bahri, N, Felah, R, Khaireddine, A, Sakouhi, M, Zakhama, A (1999) Tubo-ovarian xanthogranulomatous inflammation. Report of a case. Tunis Med 77: pp. 593-596
  5. Mesia, AF, Lam, H, Wallach, RC (2000) Xanthogranulomatous tubo-ovarian abscess resulting from chronic diverticulitis. Gynecol Obstet Invest 49: pp. 70-72 CrossRef
  6. Gray, Y, Libbey, NP (2001) Xanthogranulomatous salpingitis and oophoritis: a case report and review of the literature. Arch Pathol Lab Med 125: pp. 260-263
  7. Noack, F, Briese, J, Stellmacher, F, Hornung, D, Horny, HP (2006) Lethal outcome in xanthogranulomatous endometritis. APMIS 114: pp. 386-388 CrossRef
  8. Dogan Ekici, AI, Usubutun, A, Kucukali, T, Ayhan, A (2007) Xanthogranulomatous endometritis: a challenging imitator of endometrial carcinoma. Infect Dis Obstet Gynecol 2007: pp. 34763 CrossRef
  9. Idrees, M, Zakashansky, K, Kalir, T (2007) Xanthogranulomatous salpingitis associated with fallopian tube mucosal endometriosis: a clue to the pathogenesis. Ann Diagn Pathol 11: pp. 117-121 CrossRef
  10. Kostopoulou, E, Daponte, A, Kallitsaris, A, Papamichali, R, Kalodimos, G, Messinis, IE, Koukoulis, G (2008) Xanthogranulomatous salpingitis: report of three cases and comparison with a case of pseudoxanthomatous salpingitis. Clin Exp Obstet Gynecol 35: pp. 291-294
  11. Wu, CH, Chien, CC, Yang, HB (2009) Xanthogranulomatous inflammation of the uterus. J Obstet Gynaecol Can 31: pp. 295-296
  12. Howey, JM, Mahe, E, Radhi, J (2010) Xanthogranulomatous salpingitis associated with a large uterine leiomyoma. Case Rep Med 2010: pp. 970805
  13. Bates, AW, Fegan, AW, Baithun, SI (1998) Xanthogranulomatous cystitis associated with malignant neoplasms of the bladder. Histopathology 33: pp. 212-215 CrossRef
  14. Ashkenazy, M, Lancet, M, Borenstein, R, Czernobilsky, B (1983) Endometrial foam cells: Non-estrogenic and estrogenic. Acta Obstet Gynecol Scand 62: pp. 193-197 CrossRef
  15. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6874/14/82/prepub
  
• 刊物主题：Gynecology; Maternal and Child Health; Reproductive Medicine;
• 出版者：BioMed Central
• ISSN：1472-6874

文摘

Background Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to the normal tissue of affected organs. Although xanthogranulomatous endometritis and xanthogranulomatous salpingitis of the female genital tract has been described previously, to the best of our knowledge, this is the first report of xanthogranulomatous inflammation with infiltration into the uterine myometrium from the perimetrium without endometritis. Case presentation A 68-year-old Japanese woman with intermittent lower abdominal pain and low-grade fever who was initially treated with antibiotics underwent hysterectomy due to abscess formation in the posterior wall of the myometrium and perimetrium (the outer serosal layer of the uterus). Histopathological findings revealed that the abscess was caused by xanthogranulomatous inflammation with the granulation tissue and chronic inflammatory cells that consisted of focal and sheets of foam cells. The inflammation destroyed the perimetrial elastic lamina, and the myometrium was deeply infiltrated by the xanthoma cells. Neither endometritis nor salpingitis was coexistent with the xanthogranulomatous inflammation. Conclusion The patient was diagnosed as xanthogranulomatous inflammation, most likely arising from the perimetrium. Our findings suggest that the perimetrium, as well as the endometrium and adnexae, is one of the origins of xanthogranulomatous inflammation in female genital tract.