title: Xanthogranulomatous inflammation of the perimetrium with infiltration into the uterine myometrium in a postmenopausal woman: a case report.
abstract: BACKGROUND
  Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to the normal tissue of affected organs. Although xanthogranulomatous endometritis and xanthogranulomatous salpingitis of the female genital tract has been described previously, to the best of our knowledge, this is the first report of xanthogranulomatous inflammation with infiltration into the uterine myometrium from the perimetrium without endometritis.
  
  
  METHODS
  A 68-year-old Japanese woman with intermittent lower abdominal pain and low-grade fever who was initially treated with antibiotics underwent hysterectomy due to abscess formation in the posterior wall of the myometrium and perimetrium (the outer serosal layer of the uterus). Histopathological findings revealed that the abscess was caused by xanthogranulomatous inflammation with the granulation tissue and chronic inflammatory cells that consisted of focal and sheets of foam cells. The inflammation destroyed the perimetrial elastic lamina, and the myometrium was deeply infiltrated by the xanthoma cells. Neither endometritis nor salpingitis was coexistent with the xanthogranulomatous inflammation.
  
  
  CONCLUSIONS
  The patient was diagnosed as xanthogranulomatous inflammation, most likely arising from the perimetrium. Our findings suggest that the perimetrium, as well as the endometrium and adnexae, is one of the origins of xanthogranulomatous inflammation in female genital tract.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. katsutoshi-tky@umin.ac.jp.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Oda
authors.forename: Takahide
authors.initials: T
authors.lastname: Arimoto
authors.forename: Taiki
authors.initials: T
authors.lastname: Samejima
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takazawa
authors.forename: Daichi
authors.initials: D
authors.lastname: Maeda
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukayama
authors.forename: Kei
authors.initials: K
authors.lastname: Kawana
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osuga
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Fujii
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D005260:Female; D006099:Granuloma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D008279:Magnetic Resonance Imaging; D009215:Myometrium / Q000473:pathology*; D017698:Postmenopause; D012700:Serositis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014591:Uterine Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014599:Uterus / Q000473:pathology / Q000601:surgery; D014973:Xanthomatosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery