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黄色肉芽肿性子宫内膜炎:子宫内膜癌的一个具有挑战性的模仿者。

Xanthogranulomatous endometritis: a challenging imitator of endometrial carcinoma.

作者信息

Doğan-Ekici A Işin, Usubütün Alp, Küçükali Türkan, Ayhan Ali

机构信息

Department of Pathology, School of Medicine, Yeditepe University, Istanbul, Turkey.

出版信息

Infect Dis Obstet Gynecol. 2007;2007:34763. doi: 10.1155/2007/34763.

Abstract

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-year-old 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.

摘要

黄色肉芽肿性炎症是一种独特的组织病理学实体,可累及多个器官,主要是肾脏和胆囊。到目前为止,仅有少数发生于女性生殖道的黄色肉芽肿性炎症病例被报道,最常累及子宫内膜,其组织学特征为子宫内膜被由大量泡沫状组织细胞、含铁血黄素巨噬细胞、巨细胞、纤维化、钙化以及伴随的多克隆来源的多形核白细胞、浆细胞和淋巴细胞组成的黄色肉芽肿性炎症所取代。我们报告一例69岁女性,主诉绝经后出血和体重减轻。临床初步诊断为子宫内膜癌或增生,放射科医生通过超声检查推测为子宫内膜恶性肿瘤、增生或积脓。子宫组织病理学检查显示为黄色肉芽肿性子宫内膜炎。由于黄色肉芽肿性子宫内膜炎在临床和病理上可能因子宫内膜被由组织细胞构成的易碎淡黄色组织取代以及偶尔侵及肌层而酷似子宫内膜恶性肿瘤,因此临床医生和病理医生均需要了解这种不常见的炎症性疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9272/1939916/aa2569ac8d9c/IDOG2007-34763.001.jpg

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