Xanthogranulomatous endometritis: A case report and literature review (original) (raw)
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Xanthogranulomatous Endometritis: A Challenging Imitator of Endometrial Carcinoma
Infectious Diseases in Obstetrics and Gynecology, 2007
Xanthogranulomatous inflammation is a distinguished histopathological entity affecting several organs, predominantly the kidney and gallbladder. So far, only a small number of cases of xanthogranulomatous inflammation occurring in female genital tract have been described, most frequently affecting the endometrium and histologically characterized by replacement of endometrium by xanthogranulomatous inflammation composed of abundant foamy histiocytes, siderophages, giant cells, fibrosis, calcification and accompanying polymorphonuclear leucocytes, plasma cells and lymphocytes of polyclonal origin. We present a case of a 69-yearold female complained of post menopausal bleeding and weight loss. Clinical preliminary diagnoses were endometrial carcinoma or hyperplasia and ultrasound was supposed to be endometrial malignancy, hyperplasia or pyometra by radiologist. Histopathological examination of uterus revealed xanthogranulomatous endometritis. Since xanthogranulomatous endometritis may mimic endometrial malignancy clinically and pathologically as a result of the replacement of the endometrium and occasionally invasion of the myometrium by friable yellowish tissue composed of histiocytes, knowledge of this unusual inflammatory disease is needed for both clinicians and pathologists.
Xanthogranulomatous Endometritis with calculus formation in setting of prolapsed uterus
Autopsy Case Reports
Xanthogranulomatous inflammation is a rare benign inflammatory lesion characterized by sheets of lipid-laden foamy histiocytes. It has been reported in various organs, mainly the kidney and gall bladder. Xanthogranulomatous endometritis (XGE) is sporadic, with only a few cases reported in the English medical literature. Herein, we report a case of xanthogranulomatous endometritis with the formation of stones in a 50-year-old female patient with a prolapsed uterus. Grossly the endometrium was irregular, and the uterine cavity was filled with a yellow friable material, a polypoid growth, and yellowish stones. The microscopy showed sheets of histiocytes with few preserved endometrial glands. In this case, the xanthogranulomatous inflammation may mimic a clear cell carcinoma involving the endometrium and myometrium. One of the important differential diagnoses is malakoplakia. Immunohistochemistry and special stains are helpful in diagnosis.
Xanthogranulomatous endometritis presenting as pyometra and mimicking carcinoma on imaging
Journal of mid-life health
Xanthogranulomatous endometritis (XGE) is an uncommon but well-established histopathological entity seen affecting the kidney and gallbladder. Involvement of the endometrium is very rare, with only a few case reports in world literature till date. Histologically, it is characterized by the replacement of the endometrium by sheets of foamy histiocytes, plasma cells, lymphocytes, giant cells, and siderophages. We present a case of a 74-year-old female who presented with foul-smelling discharge and postmenopausal bleeding of a short duration. Clinical examination and imaging studies revealed a pyometra, cervical stenosis. A suspicion of carcinoma was raised. Since XGE may mimic an endometrial carcinoma clinically and pathologically, knowledge of this unusual and rare inflammatory pathology is important for both the gynecologists and the pathologists.
Journal of Case Reports and Images in Obstetrics and Gynecology, 2019
A case of xanthogranulomatous salpingitis is presented in a 36-year-old woman with a longstanding history of chronic pelvic pain on a background of endometriosis. The presentation of endometriosis in this case is that of hemorrhagic ascites which is a rare occurrence. Xanthogranulomatous salpingitis is a rare form of chronic inflammation involving the fallopian tube, and it is characterized by the presence of lipid-laden macrophages and other chronic inflammatory cells within the wall of the fallopian tube. There are only a few cases of xanthogranulomatous inflammation affecting the female genital tract which are reported in the medical literature.
Xanthogranulomatous inflammation: a rare cause of premature ovarian failure
Archives of Gynecology and Obstetrics, 2009
Xanthogranulomatous inXammation is rare, mainly involving the kidneys, histologically characterized by partial or complete replacement of the mucosa by granulation tissue with an abundance of foamy histiocytes, siderophages and multinucleated giant cells. We report an unusual presentation of xanthogranulomatous inXammation of the genital tract in a young female presenting with premature ovarian failure. A 25-year-old unmarried female presented to the gynecology OPD with amenorrhea and lump abdomen for one and half years with weight loss and mucoid discharge per rectum for 2 months. On investigating, CECT showed a heterogeneously enhancing mass lesion with solid cystic components in pelvis. Cystic components showed enhancing walls and air Xuid levels. Uterus and ovaries were not seen separately. There were multiple lymph nodes in retroperitoneum. Both LH and FSH were raised to post menopausal levels (FSH-69.35, LH-64.53). A provisional diagnosis of ovarian malignancy was made and a diVerential diagnosis of genital tuberculosis was kept and a decision for laparotomy was taken. Intraoperatively, there was a mass arising from the right side of fundus stuck to rectum. There was a pus pocket in the tumor. The Wnal histopathological report was suggestive of endometrioma with xanthogranulomatous inXammation involving adjacent ovary and fallopian tube.
Annals of diagnostic pathology, 2007
Xanthogranulomatous salpingitis is an unusual inflammatory lesion of the fallopian tube, characterized by accumulation of foamy macrophages in the wall of the fallopian tube along with other chronic inflammatory cells. Only a few cases of xanthogranulomatous salpingitis have been reported in the English medical literature, some under different nomenclature. An association, most commonly with pelvic inflammatory disease and endometriosis, has been suggested. A 41-year-old woman with prior history of breast carcinoma underwent bilateral salpingoophorectomy because of hematosalpinx. The histology revealed xanthogranulomatous salpingitis in the setting of extensive fallopian tube mucosal endometriosis, endometritis, and presence of an intrauterine contraceptive device. Multiple etiologies have been linked to the xanthogranulomatous process at this location in previously reported cases. A whole spectrum of changes may exist in this lesion and probably represent a specialized form of tiss...
Journal of Obstetrics and Gynaecology Research, 2012
Xanthogranulomatous inflammation is a rare form of chronic granulomatous inflammation. Bacterial infections, immunosuppression, chronic inflammatory conditions, luminal obstruction, endometriosis, leiomyoma, abnormal lipid metabolism, ineffective antibiotic therapy, ineffective clearance of bacteria by phagocytes and chronic irritation of the urachal remnant have been implicated in the pathogenesis. There are very few reported cases of xanthogranulomatous salpingitis and oophoritis. We present such a case in a 34‐year‐old female, with primary subfertility for eight years, endometriosis, uterine leiomyoma, type II diabetes mellitus and a history of surgery for endometriosis and fibroids and surgical wound infection, who presented with symptoms of intestinal obstruction. The patient underwent emergency laparotomy followed by total abdominal hysterectomy and bilateral salpingo‐oophorectomy. Histology revealed xanthogranulomatous salpingitis and oophoritis. Chronic inflammation due to i...
Xanthogranulomatous Degeneration in a Leiomyoma – First Documentation
Online Journal of Health & Allied Sciences, 2021
Xanthogranulomatous inflammation of the female genital tract is rare with documented cases confined to the endometrium, fallopian tube, and ovary. A careful search of English literature yielded only two reports pf myometrial involvement by xanthgranulomatous inflammation. Herein, we present a case of 37-year-old diabetic female with a previously diagnosed anterior wall fibroid who presented with lower abdominal pain. A repeat transvaginal sonography confirmed the presence of a fundal subserosal fibroid with degenerative changes. The patient underwent myomectomy and there were no adhesions or involvement of adnexa in intraoperative examination. Pathological examination of the same revealed leiomyoma with degenerative changes and xanthogranulomatous inflammation. The present case of xanthogranulomatous degeneration occurring de-novo in a leiomyoma, is to the best of our knowledge the first documentation of this entity.
Xanthogranulomatous inflammatory lesions: a 10-year clinicopathological study in a teaching hospital
Bangladesh Journal of Medical Science, 2014
Objective: To review the demographic, clinical and histomorphological aspects of xanthogranulomatous inflammation (XGI) in different organs. Material and methods: All the cases diagnosed as XGI by histopathology from the specimens received in the department of Pathology, Regional Institute of Medical Sciences, Imphal, Manipur, India over the period of 10 years from January 2001 to December 2010 were included in the study. All the available data including age, sex, organ of involvement, association with stone etc. were collected and analyzed retrospectively. All the slides were reviewed. The results were recorded and analyzed. Results: A total of 98 cases of XGI were diagnosed out of a total of 9755 specimens received, constituted by 5382 of gall bladder, 4298 of appendix, 41 of kidney and 24 of tube and tubo-ovarian mass making an overall incidence of 1%. The incidence of XGI in kidney was 12.19%, followed by 4.16% in tube and tubo-ovarian mass, 1.5% in gall bladder and 0.25% in app...
Xanthogranulomatous Oophoritis- A Rare Inflammatory Lesion
Xanthogranulomatous inflammation is a special form of chronic inflammation that is destructive of affected organ. Xanthogranulomatous inflammation of ovary and fallopian tube is an uncommon entity and it is usually known to occur in the kidney and gall bladder. Patients with xanthogranulomatous oophoritis present with lower abdominal or suprapubic pain, fever, menorrhagia or vaginal bleeding, adnexal tenderness and a pelvic mass. This entity can be confused with ovarian tumour on clinical and radiological features. According to our search in the literature 16 cases of xanthogranulomatous oophoritis have been reported. We report a 30 year old female, presented with a unilateral ovarian mass with clinical and radiological suspicion of ovarian tumour. Patient underwent panhysterectomy, grossly the right ovary was enlarged and on cut section it was solid with yellowish areas. Histopathological examination revealed massive infiltration of the ovarian tissue and fallopian tube by lipidlad...