1/3. Lethal outcome in xanthogranulomatous endometritis.Xanthogranulomatous inflammation is rare, mainly involving the kidneys, while primary xanthogranulomatous endometritis (XE) is a very unusual finding, 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 present the case of a 69-year-old woman with a short history of abdominal pain and a palpable mass in the pouch of Douglas. dilatation of the cervix drained a pyometra. Histological examination of the curettage rendered the diagnosis of XE. Microbiological studies revealed enterococcus spp. and peptostreptococcus magnus. Despite antibiotic treatment the patient died of heart failure due to systemic inflammation. autopsy confirmed the diagnosis of XE with transmural extension into the peritoneal cavity. Such a lethal course of XE is extraordinary. Proposed causes of XE include obstruction, infection and hemorrhage. Demonstration of enterococcus spp. and P. magnus supports the probable significance of bacteria in the development of XE. Because this condition may mimic malignant disease macroscopically and histologically, knowledge of XE is of major importance for both pathologists and gynecologists.- - - - - - - - - - ranking = 1keywords = xanthogranulomatous (Clic here for more details about this article) |
2/3. Xanthogranulomatous endometritis associated with endometrial carcinoma.We studied a case of xanthogranulomatous (XG) endometritis associated with endometrial adenocarcinoma. Isolated XG endometritis is a rare entity that may mimic carcinoma as a consequence of the replacement of the endometrium and the invasion of the myometrium by friable yellowish tissue composed of foamy histiocytes. To our knowledge, it has not previously been described as coexisting with a carcinoma. The XG reaction is characterized by pigment-laden foamy cells. Electron microscopy demonstrated that the foamy cells belong to the macrophage/histiocyte series and are not endometrial stromal cells. Histochemical studies revealed the pigment to be composed of hemosiderin and lipofuscin. The absence of calcispherites or a uniform immunoperoxidase staining reaction for alpha 1-antitrypsin excluded the diagnosis of malacoplakia. We have postulated that XG endometritis has a similar etiopathogenesis to XG pyelonephritis and XG cholecystitis. It is a rare morphologic expression of the clinical syndrome of benign senile pyometrium.- - - - - - - - - - ranking = 0.2keywords = xanthogranulomatous (Clic here for more details about this article) |
3/3. Xanthogranulomatous endometritis: case report.A case of chronic endometritis with unusual histological features due to the presence of abundant foam cells and lipid material is described. The presence of foam cells, abundant intra- and extracellular lipid together with other inflammatory cells in the absence of endometrial hyperplasia or carcinoma warrants the diagnosis of xanthogranulomatous endometritis.- - - - - - - - - - ranking = 0.2keywords = xanthogranulomatous (Clic here for more details about this article) |