Xanthogranulomatous Change in a Leiomyoma: First Report of an Extremely Rare Variant/Degenerative Change

Abstract

Xanthogranulomatous inflammation, a specific form of chronic inflammation, is marked by parenchymal destruction, proliferative fibrosis, and infiltration of typical foamy histiocytes admixed with hemosiderin-laden macrophages and foreign-body giant cells. Myometrial xanthomatosis, a term designated for nodular or diffuse histiocytic hyperplasia of the myometrium, has been reported in association with pregnancy-related procedures. Moreover, a 2–3-fold increase in histiocytic counts has been observed in leiomyomatous areas than in adjacent normal myometrium. The first evidence of collections of lipid-laden macrophages was documented in the form of yellowish degeneration of uterine leiomyomas. We report a case of xanthogranulomatous change in a leiomyoma in a 47-year-old female who presented with abnormal uterine bleeding. To the best of our knowledge, this is the first report of xanthogranulomatous variant/degenerative change in a leiomyoma. This case highlights a new variant of leiomyoma which both gynecologists and pathologists should be aware of as it may pose a diagnostic challenge both clinically as well as pathologically.

Exploring the Diagnostic Challenges of Uterine Lesions in Frozen Section: A Comprehensive Study at a Tertiary Care Center

“…Xanthogranulomatous inflammation is a rare form of chronic inflammation, which destroys the organ tissue that is affected [ 6 , 7 , 8 ]. It is most commonly seen in the kidneys and the gall bladder [ 6 , 9 ].…”

“…This demonstrates that frozen section analysis is a valuable tool for surgeons in on-table decision-making regarding the management of uterine masses during surgery (Table 6). Xanthogranulomatous inflammation is a rare form of chronic inflammation, which destroys the organ tissue that is affected [6,7,8]. It is most commonly seen in the kidneys and the gall bladder [6,9].…”