Department of Diagnostic Pathology, Ina Central Hospital, Ina, Japan.
Department of Laboratory Medicine, Ina Central Hospital, Ina, Japan.
Pathologica. 2021 Dec;113(6):442-448. doi: 10.32074/1591-951X-193.
We present a rare case of phosphoglyceride crystal deposition disease (PCDD), as a gynecologic disease, with reference to histogenesis of crystal deposition. An 84-year-old woman, who had undergone simple hysterectomy for uterine leiomyoma 44 years previously, presented with multiple masses in the bilateral adnexa and the pelvic wall. The bilateral adnexal tumors were resected. The masses histologically revealed a foreign-body granuloma composed of numerous tiny, radially arranged needle-like crystal lumps surrounded by multinucleated giant cells and macrophages. The crystals showed birefringence under polarized light and were positive for gold hydroxamic acid stain, and the tumor was thus diagnosed as PCDD. The masses revealed central cystic changes due to old hemorrhage, which contained crystal lumps without foreign-body reaction or birefringence. The present case demonstrated for the first time that phosphoglyceride crystals developed in old hemorrhagic foci, although it was not confirmed whether the old hemorrhagic foci were formed after hysterectomy or due to endometriosis.
我们报告了一例罕见的磷酯酰甘油晶体沉积病（PCDD），它是一种妇科疾病，并参考了晶体沉积的组织发生。一位 84 岁的女性，44 年前因子宫肌瘤行单纯子宫切除术，现在双侧附件和骨盆壁有多个肿块。双侧附件肿瘤被切除。肿块的组织学显示为异物性肉芽肿，由许多微小的、放射状排列的针状晶体块组成，周围有多核巨细胞和巨噬细胞。这些晶体在偏振光下呈现双折射，并且对金羟肟酸染色呈阳性，因此诊断为 PCDD。肿块由于陈旧性出血而呈现中央囊性变化，其中含有无异物反应或双折射的晶体块。本病例首次表明，磷酯酰甘油晶体在陈旧性出血灶中形成，尽管尚未确定陈旧性出血灶是在子宫切除术后形成的，还是由于子宫内膜异位症引起的。
