Biscotti C V, Hart W R, Lucas J G
Department of Pathology, Cleveland Clinic Foundation, Ohio.
Obstet Gynecol. 1989 Sep;74(3 Pt 2):492-5.
Autoimmune oophoritis is a rare cause of premature ovarian failure. Previous studies of autoimmune oophoritis have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have not been emphasized. Herein, we describe a 35-year-old woman with autoimmune oophoritis who presented with symptoms referable to a right cystic adnexal mass. She underwent a diagnostic laparotomy and right salpingo-oophorectomy for removal of an 8.0-cm-diameter, twisted multicystic ovary. Microscopically, mononuclear inflammatory cells infiltrated multiple follicular and luteal cysts. We have seen two additional patients with histologically verified autoimmune oophoritis who underwent diagnostic laparotomy and oophorectomy because of cystic enlargement of the ovaries. Stimulation of ovarian follicles by elevated levels of pituitary gonadotropins probably causes the cystic changes. Recognition of this aspect of autoimmune oophoritis may help to prevent oophorectomy in patients whose functioning ovarian tissue is already compromised by autoimmune destruction.
自身免疫性卵巢炎是卵巢早衰的罕见病因。既往关于自身免疫性卵巢炎的研究详细阐述了其临床、免疫学及组织学表现。受累卵巢的大体病理特征尚未得到重视。在此，我们描述一名35岁患有自身免疫性卵巢炎的女性，她表现出与右侧囊性附件包块相关的症状。她接受了诊断性剖腹手术及右侧输卵管卵巢切除术，以切除一个直径8.0厘米、扭转的多囊卵巢。显微镜下，单核炎性细胞浸润多个卵泡囊肿和黄体囊肿。我们还见过另外两名经组织学证实为自身免疫性卵巢炎的患者，她们因卵巢囊性增大而接受了诊断性剖腹手术及卵巢切除术。垂体促性腺激素水平升高对卵巢卵泡的刺激可能导致了囊性改变。认识到自身免疫性卵巢炎的这一方面，可能有助于避免对卵巢功能组织已因自身免疫破坏而受损的患者进行卵巢切除术。
