Cases reported "Oophoritis"

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1/3. Autoimmune oophoritis--a case report.

    A case is described of an autoimmune oophoritis that was diagnosed unexpectedly after a hysterectomy and bilateral salpingo-oophorectomy had been performed on the suspicion of ovarian cysts. The patient was a 43-year-old multiparous woman who presented with vaginal bleeding and lower abdominal pain which she had had for one month. Grossly, the ovaries were enlarged and multicystic. The cysts measured up to 3.0 cm. The major histological change was a lymphoplasmacytic infiltrate in close relation to the theca interna of developing, cystic and atretic follicles, but sparing the primordial follicles. The infiltrate increased in density with the follicular maturation and culminated against the corpus luteum. With involution of the developing follicles, the inflammatory infiltrate subsided to some extent. The proportion of the plasma cells increased with the density of the infiltrates. Immunohistochemical study of the ovarian mononuclear cell infiltrate revealed a mixture of B- and t-lymphocytes. The plasma cells were polyclonal. These histological features of the present case are typical of autoimmune oophoritis although the presence of autoantibodies and hormonal level in the patient's serum were unknown. This case may be identified as in the early active stage of autoimmune oophoritis.
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2/3. Autoimmune oophoritis.

    A 43-year-old para 3 woman presented with a six-year history of progressive oligomenorrhea and hypomenorrhea. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed for the suspicion of ovarian cysts. On histologic examination, the ovaries contained lymphocytic and plasma cell infiltrates in relation to the theca interna of growing follicles, to the corpora lutea and to the endocrine hilar cells. The infiltrates increased in density with the follicular maturation and culminated against the corpora lutea. The plasma cell population was polyclonal. No antibodies to ovarian tissue components could be demonstrated in the patient's serum by means of immunohistochemistry; but antibodies to the zona glomerulosa of adrenal cortex were detected by serologic means. Although a rare disease, autoimmune oophoritis must be recognized histologically because it is a cause of ovarian failure and because it indicates that the patient is at risk of developing associated Addison's disease.
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3/3. Eosinophilic perifolliculitis: a variant of autoimmune oophoritis?

    We report two middle-aged women with ovarian perifolliculitis consisting mostly of eosinophils. Both had enlarged cystic ovaries that on histological examination showed a perifollicular inflammatory infiltrate consisting of lymphocytes, plasma cells, and large numbers of eosinophils. The inflammatory infiltrate increased in intensity with follicular maturation and appeared to be destroying the theca interna. Circulating antiovarian, antiadrenal, and antithyroid antibodies were negative in both cases. We also compare these cases to lymphoplasmacytic autoimmune oophoritis.
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