Maeda Yuto, Uematsu Kazuhiko, Matsubayashi Aya, Yoshioka Shinya
Department of Obstetrics, National Center for Child Health and Development, Tokyo, Japan.
Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital, Kobe, Japan.
J Obstet Gynaecol Res. 2019 Aug;45(8):1588-1592. doi: 10.1111/jog.13999. Epub 2019 May 20.
Pulse granuloma, a benign granulomatous lesion, develops due to foreign body reactions to food particles. This rare entity occurs occasionally in the abdominal cavity. However, it has never been reported as a pelvic mass or a recurrent case. A 37-year-old woman with a medical history of pelvic granulomatous lesions treated in Thailand, was admitted for abdominal pain. Imaging study revealed a pelvic complex cyst and disseminated nodules. Ovarian cancer or tuberculous peritonitis was suspected. The appearance at laparotomy was an inflammatory mass encased in adhesions; therefore, only biopsy was performed. The pathology diagnosis was pulse granuloma. The pathology report from Thailand was obtained only after her discharge, suggesting that the previous granulomatous lesion contained vegetable matter. This report demonstrates that pulse granuloma can present as a pelvic mass and may relapse. For complex cystic lesions with solid components in the pelvis, pulse granuloma should be considered as a differential diagnosis.
脉冲肉芽肿是一种良性肉芽肿性病变，由对食物颗粒的异物反应引起。这种罕见的病变偶尔发生于腹腔。然而，从未有作为盆腔肿块或复发病例的报道。一名37岁有盆腔肉芽肿性病变病史且曾在泰国接受治疗的女性因腹痛入院。影像学检查显示盆腔有一个复杂囊肿和散在结节。怀疑为卵巢癌或结核性腹膜炎。剖腹探查时所见为包裹在粘连中的炎性肿块；因此仅进行了活检。病理诊断为脉冲肉芽肿。泰国的病理报告在她出院后才拿到，提示先前的肉芽肿性病变含有植物物质。本报告表明脉冲肉芽肿可表现为盆腔肿块且可能复发。对于盆腔内有实性成分的复杂囊性病变，应考虑脉冲肉芽肿作为鉴别诊断。
