Chetty Runjan, Reddy Isaivani, Batitang Sixto
Department of Pathology, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.
Arch Pathol Lab Med. 2003 Nov;127(11):e417-9. doi: 10.5858/2003-127-e417-XOXOTF.
We report a case of a 24-year-old woman who presented with abdominal pain, a tense abdomen, and rebound tenderness. A vague, ill-defined mass was palpated, and an ultrasound examination revealed a cystic lesion in the left adnexal region. At laparotomy, a slightly dilated fallopian tube was seen and excised. Light microscopy showed intact fallopian tube mucosa, with a diffuse infiltrate of foam cells in the lamina propria. There were no associated inflammatory cells. The foam cells were positive for CD68 and negative for AE1/AE3. Discontinuous areas of the epithelium also showed epithelial cells with "foamy cytoplasm." These cells were negative for CD68 but positive for AE1/AE3. To our knowledge, this represents the first case of a fallopian tube xanthelasma that shows a resemblance to lesions encountered in the stomach. Fallopian tube xanthelasma must be distinguished from xanthogranulomatous salpingitis, which is associated with an inflammatory cell infiltrate, often including giant cells. However, this lesion may share pathogenetic similarities with xanthogranulomatous salpingitis, since both processes are mediated by inflammation.
我们报告一例24岁女性患者，其表现为腹痛、腹部紧张及反跳痛。触诊可摸到一个边界不清、形态模糊的肿块，超声检查显示左侧附件区有一个囊性病变。剖腹手术时，可见一条轻度扩张的输卵管并将其切除。光镜检查显示输卵管黏膜完整，固有层有泡沫细胞弥漫浸润。未见相关炎性细胞。泡沫细胞CD68阳性，AE1/AE3阴性。上皮的不连续区域也可见到具有“泡沫状胞质”的上皮细胞。这些细胞CD68阴性，但AE1/AE3阳性。据我们所知，这是首例与胃内病变相似的输卵管睑黄瘤病例。输卵管睑黄瘤必须与伴有炎性细胞浸润（常包括巨细胞）的黄色肉芽肿性输卵管炎相鉴别。然而，该病变可能与黄色肉芽肿性输卵管炎有发病机制上的相似性，因为这两种病变均由炎症介导。
