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Recurrent pyometra and xanthogranulomatous salpingitis: A rare pathologic association in a postmenopausal lady.

Gami N, Mundhra R, Guleria K, Arora VK, Garg S - J Midlife Health (2014)

Bottom Line: Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation.She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination.Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India.

ABSTRACT
Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation. Of the 15 reported cases of Xanthogranulomatous endometritis, majority (60%) were accompanied by endometrial carcinoma. We herein report a case of a postmenopausal woman presenting with recurrent pyometra who was suspected to be case of cervical tuberculosis and treated for the same. Inspite of antitubercular therapy, she had cervical stenosis and developed recurrent pyometra over the next 2 years requiring repeated drainage. She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination. Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients.

No MeSH data available.


Related in: MedlinePlus

Pap smear showing histiocytic granuloma
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Figure 1: Pap smear showing histiocytic granuloma

Mentions: 60-years-old, P7 L7, postmenopausal lady presented with complaints of foul smelling pus like discharge per vaginum for 3 months. She was a known hypertensive and is on regular medication. General physical and abdominal examination was unremarkable. Per Speculum examination revealed an inflamed cervix, flushed with the vagina and pus like discharge coming through os. On per vaginal examination, uterus was bulky, bilateral fornices were free. Pelvic ultrasound revealed intrauterine collection. Pap smear was taken and cervical dilatation with pyometra drainage was done. Around 5 cc pus was drained. Pus culture was sterile and negative for acid fast bacilli. Pap smear showed granulomatous cervicitis [Figure 1] and based on it the patient was started on anti-tubercular therapy for 6 months. Nine months later, the woman presented with blood mixed discharge per vaginum and underwent dilatation and curettage which suggested chronic endometritis. A repeat Pap smear was done and it showed inflammatory smear. Antibiotic course was given with an advice to follow-up.


Recurrent pyometra and xanthogranulomatous salpingitis: A rare pathologic association in a postmenopausal lady.

Gami N, Mundhra R, Guleria K, Arora VK, Garg S - J Midlife Health (2014)

Pap smear showing histiocytic granuloma
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4195190&req=5

Figure 1: Pap smear showing histiocytic granuloma
Mentions: 60-years-old, P7 L7, postmenopausal lady presented with complaints of foul smelling pus like discharge per vaginum for 3 months. She was a known hypertensive and is on regular medication. General physical and abdominal examination was unremarkable. Per Speculum examination revealed an inflamed cervix, flushed with the vagina and pus like discharge coming through os. On per vaginal examination, uterus was bulky, bilateral fornices were free. Pelvic ultrasound revealed intrauterine collection. Pap smear was taken and cervical dilatation with pyometra drainage was done. Around 5 cc pus was drained. Pus culture was sterile and negative for acid fast bacilli. Pap smear showed granulomatous cervicitis [Figure 1] and based on it the patient was started on anti-tubercular therapy for 6 months. Nine months later, the woman presented with blood mixed discharge per vaginum and underwent dilatation and curettage which suggested chronic endometritis. A repeat Pap smear was done and it showed inflammatory smear. Antibiotic course was given with an advice to follow-up.

Bottom Line: Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation.She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination.Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India.

ABSTRACT
Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation. Of the 15 reported cases of Xanthogranulomatous endometritis, majority (60%) were accompanied by endometrial carcinoma. We herein report a case of a postmenopausal woman presenting with recurrent pyometra who was suspected to be case of cervical tuberculosis and treated for the same. Inspite of antitubercular therapy, she had cervical stenosis and developed recurrent pyometra over the next 2 years requiring repeated drainage. She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination. Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients.

No MeSH data available.


Related in: MedlinePlus