Xanthogranulomatous Inflammation of the Female Genital Tract: Report of Three Cases

Abstract

Purpose and Methods: This is a series of three cases diagnosed with xanthogranulomatous inflammation of the female genital with emphasis on the etiology, clinical-pathologic features and biological behavior. Clinical, pathologic, radiologic and follow up data are reported.Results: The three cases of Xanthogranulomatous inflammation of the female genital tract are the followings: 1) one case affecting the endometrium, 2) one case affecting the fallopian tube, and 3) one case confined to the ovary. The patient's age was 37, 22 and 62 year-old, respectively. Histologic examination revealed extensive infiltration of foamy histiocytes admixed with variable amount of inflammatory cells. The later include plasma cells, lymphocytes, and occasional multinucleated giant cells. Immunohistochemistry showed positive staining for CD68, a histiocytic marker, in foamy histiocytes, CD3, a T cell marker, and CD20, a B cell marker, in the background lymphocytes. The plasma cells were polyclonal with expression of both κ and λ light chains.Conclusion: Xanthogranulomatous inflammation of the female genital tract is an unusual lesion, and clinically forms mass- like lesion in the pelvic cavity that invades the surrounding tissues, which may mimic the tumor clinically and by imaging.

Xanthogranulomatous oophoritis: a rare chronic inflammatory non-neoplastic ovarian pseudotumor

“…Many theories have been proposed, such as theory of infection, leomyoma, endometriosis, use of IUCD, inefficient or inappropriate drugs (antibiotics) etc. 4 The theory of infection is supported by the clinical evidence of infection and growth of bacteria such as Escherichia coli, Bacteroides fragilis, Proteus vulgaris, and Salmonella …”

Serous cystadenoma of ovary with xanthogranulomatous oophoritis: combination of benign ovarian tumour with chronic inflammatory non-neoplastic pseudo-tumour-a rarity

“…Involvement can be either focal or generalised and forms masses in the pelvic cavity and may invade the surrounding structures as well. 2,3 Kunakemakorn was the first to report inflammatory pseudotumor in the pelvis in serosa of the uterus, left fallopian tube and ovary. 4 Among various literature and case reports, only 16 related cases of Xanthogranulomatous inflammation involving fallopian tube or ovary have been described so far.…”

“…Foci of necrosis may also be present in the inflamed tissue. 1,2 It is commonly found in the kidney, renal pelvis and rarely in organs like ovary and fallopian tube. Other organs in which it has been reported are stomach, anorectum, bone, urinary bladder, testes, epididymis, vagina and endometrium.…”

Xanthogranulomatous inflammation of the ovary with the uterine adenomatoid tumor in a patient with diabetes mellitus: A case report

“…Xanthogranulomatous inflammation is one of the destructive forms of chronic inflammmation (8). Massive infiltration of the tissues by lipid-laden histiocytes mixed with lymphocytes, plasma cells and polymorphonuclear leukocytes are the histologic characteristics of the xanthogranulomatous inflammation (8).…”

“…Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that may affect various organs like kidney, gallbladder, stomach, bone, urinary bladder, testis, epididymis, vagina and endometrium (8). But xanthogranulomatous inflammation of the female genital tract, especially of the ovary is very rare (9,10).…”