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Foamy histiocytes in higher power view (case 1).
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Figure 2: Foamy histiocytes in higher power view (case 1).

Mentions: Microscopic examination: All specimens were fixed in 10% formalin, dehydrated in descending grades of alcohol, sections were paraffin embedded and processed for histologic and immunohistochemical stains. The pathological changes were composed of mixed inflammatory cells and focal foamy histiocytes. The inflammatory cells were mainly lymphocytes admixed with plasma cells, small number of neutrophils and eosinophils (Figure 1). The foamy histiocytes were focally scattered, with abundant cytoplasm, small lipid vacuoles and hypochromatic nuclei (Figure 2). Multinucleated giant cells were not observed. In the stroma, fibroplasia with fibrosis, vascular proliferation with sclerosis in arterioles, hyperplasia and swelling in blood capillary endothelial lining were observed. The fibrous pseudocapsule was infiltrated with chronic inflammatory cells. Periodic acid-schiff (PAS) and acid fast stains were negative. The subsequent immunohistochemical stains demonstrated positive CD20, CD5, CD79a, κ and λ. The pathological diagnosis rendered as xanthogranulomatous oophoritis.

Xanthogranulomatous Inflammation of the Female Genital Tract: Report of Three Cases

Zhang XS, Dong HY, Zhang LL, Desouki MM, Zhao C - J Cancer (2012)

Bottom Line: The patient's age was 37, 22 and 62 year-old, respectively.Immunohistochemistry showed positive staining for CD68, a histiocytic marker, in foamy histiocytes, CD3, a T cell marker, and CD20, a B cell marker, in the background lymphocytes.The plasma cells were polyclonal with expression of both κ and λ light chains.Conclusion: Xanthogranulomatous inflammation of the female genital tract is an unusual lesion, and clinically forms mass- like lesion in the pelvic cavity that invades the surrounding tissues, which may mimic the tumor clinically and by imaging.

Affiliation: 1. Department of Pathology , Binzhou Medical College, Binzhou 256603, China;

ABSTRACT
Purpose and Methods: This is a series of three cases diagnosed with xanthogranulomatous inflammation of the female genital with emphasis on the etiology, clinical-pathologic features and biological behavior. Clinical, pathologic, radiologic and follow up data are reported.Results: The three cases of Xanthogranulomatous inflammation of the female genital tract are the followings: 1) one case affecting the endometrium, 2) one case affecting the fallopian tube, and 3) one case confined to the ovary. The patient's age was 37, 22 and 62 year-old, respectively. Histologic examination revealed extensive infiltration of foamy histiocytes admixed with variable amount of inflammatory cells. The later include plasma cells, lymphocytes, and occasional multinucleated giant cells. Immunohistochemistry showed positive staining for CD68, a histiocytic marker, in foamy histiocytes, CD3, a T cell marker, and CD20, a B cell marker, in the background lymphocytes. The plasma cells were polyclonal with expression of both κ and λ light chains.Conclusion: Xanthogranulomatous inflammation of the female genital tract is an unusual lesion, and clinically forms mass- like lesion in the pelvic cavity that invades the surrounding tissues, which may mimic the tumor clinically and by imaging.

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