Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio.
Int J Gynecol Pathol. 2020 Sep;39(5):468-472. doi: 10.1097/PGP.0000000000000625.
There are approximately a dozen cases of xanthogranulomatous salpingitis reported in the literature, mostly as case reports. Thirteen such cases were identified from 2003 to 2018 at our institution. Patient's ages ranged from 21 to 75 yr old (median and mean, 49 yr). Clinical presentations and surgical indications included pelvic inflammatory disease (5 cases), endometrial carcinoma (4 cases), suspicion of ovarian malignancy (1 case), symptomatic fibroids (1 case), endometriosis (1 case), and infertility (1 case). Surgical-pathologic correlation resulted in diagnoses of tubo-ovarian abscess (4 cases), ovarian abscess (2 cases), pyosalpinx (2 cases), and chronic endometritis (2 cases). Of the remaining 3 cases, 2 presented clinically as pelvic inflammatory disease and the other was seen in the context of an endometrial carcinoma. In summary, this case series from a single institution shows that xanthogranulomatous salpingitis is an uncommon form of chronic inflammation that may be diagnosed from reproductive to menopausal age. With one exception, the cases in this series represent pelvic inflammatory disease despite variable clinical presentations. Pseudoxanthomatous salpingitis should be in the differential diagnosis.
文献中报道了约 12 例黄肉芽肿性输卵管炎病例，其中大多数为病例报告。在我们机构，从 2003 年到 2018 年共发现了 13 例此类病例。患者年龄从 21 岁到 75 岁不等（中位数和平均值为 49 岁）。临床表现和手术指征包括盆腔炎（5 例）、子宫内膜癌（4 例）、卵巢恶性肿瘤可疑（1 例）、症状性肌瘤（1 例）、子宫内膜异位症（1 例）和不孕（1 例）。手术病理相关性诊断为输卵管卵巢脓肿（4 例）、卵巢脓肿（2 例）、脓性输卵管炎（2 例）和慢性子宫内膜炎（2 例）。在其余 3 例中，2 例临床表现为盆腔炎，另 1 例发生在子宫内膜癌的背景下。总之，来自单一机构的这个病例系列表明，黄肉芽肿性输卵管炎是一种罕见的慢性炎症形式，可能发生在生殖到绝经年龄。除 1 例外，本系列中的病例均代表盆腔炎，尽管临床表现不同。假性黄瘤性输卵管炎应作为鉴别诊断。
