Inflammatory pseudotumor of pelvic lymph nodes.
BACKGROUND
Inflammatory pseudotumor is a rare benign cause of lymphadenopathy previously reported in several anatomic locations that can simulate malignant neoplasm.


METHODS
A postmenopausal woman presented with abdominal pain, generalized malaise, leukocytosis, and intermittent fevers up to 102 degrees F. A 5-day course of antibiotics was given with persistence of symptoms. Computed tomography of the abdomen and pelvis demonstrated an ill-defined, retroperitoneal soft-tissue density, and lymphadenopathy. She underwent an exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and unilateral pelvic and paraaortic lymphadenotomy. Histologic examination revealed inflammatory pseudotumor of the lymph nodes, with immunohistochemical studies demonstrating actin-positive myofibroblastic cells. Four months after surgery, the patient remains asymptomatic without evidence of disease.


CONCLUSIONS
Inflammatory pseudotumor of the pelvic lymph nodes is a rare entity and should be included in the differential diagnosis of patients with persistent fever and lymphadenopathy.
Spannuth
Whitney A
WA
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA. Wspannuth1196@charter.net
Leath
Charles A
CA
Conner
Michael G
MG
Alvarez
Ronald D
RD
D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005334:Fever; D006104:Granuloma, Plasma Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000473:pathology / Q000601:surgery; D007964:Leukocytosis; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010052:Ovariectomy; D017699:Pelvic Pain; D010388:Pelvis; D017698:Postmenopause; D014057:Tomography, X-Ray Computed; D014594:Uterine Neoplasms / Q000473:pathology / Q000601:surgery