Obstet Gynecol Sci.  2016 Sep;59(5):411-414. 10.5468/ogs.2016.59.5.411.

Cervical xanthogranuloma in a case of postmenopausal pyometra

• Singh A
• Vats G
• Radhika AG
• Meena P
• Radhakrisnan G

• KMID: 2391694
• DOI: http://doi.org/10.5468/ogs.2016.59.5.411

Abstract

Xanthogranuloma is a non-neoplastic presentation of chronic inflammation commonly seen in gallbladder, kidney and rarely seen in genital organs. Only one case has been reported in cervix. Here, we report a case of 60-year-old postmenopausal lady who presented with history of fever and purulent discharge per-vaginum. On speculum examination, cervix had an ulcer extending from 3 to 5 o'clock position. Uterus was bulky. On probing the ulcer, a 1-cm deep sinus was identified. Ultrasound showed enlarged uterus and fluid collection suggestive of pyometra. Pyometra was drained and cervical biopsy was taken from the ulcerated lesion; histopathology revealed granulomatous inflammation with predominantly xanthous cells suggestive of tuberculosis. High index of clinical suspicion needs to be maintained in abnormal cervix. It is a perplexing and rare entity for a clinician and also a diagnosis of exclusion; only histopathology can help for diagnosis. It mimics like malignancy and chronic infections.

Keyword

Cervix uteri; Tuberculosis; Xanthogranulomatous inflammation

MeSH Terms

Biopsy
Cervix Uteri
Diagnosis
Female
Fever
Gallbladder
Genitalia
Humans
Inflammation
Kidney
Middle Aged
Pyometra*
Surgical Instruments
Tuberculosis
Ulcer
Ultrasonography
Uterus

Figure

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  Fig. 1 (A) Ulcerative lesion on the posterior lip of cervix from 3 to 5 o'clock showing purulent discharge. (B) Contrast-enhanced computed tomography pelvis showing pyometra, obliteration of fat planes between uterus and bladder; uterus and rectum.

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  Fig. 2 (A) Histopathology slide of cervical biopsy showing numerous granulomas in the cervical stoma (H&E, ×40). (B) Epithelioid cell granuloma with Langhan's giant cell is seen beneath the ulcerated epithelium (H&E, ×100).

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