Autoimmune oophoritis: a case report

In: Journal of Korean Medical Science · 1992 · vol. 7(3) , pp. 284 · doi:10.3346/jkms.1992.7.3.284 · PMID:1285930 · W2053442897
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This case report describes autoimmune oophoritis characterized by lymphoplasmacytic infiltrates related to ovarian follicles, identified after a hysterectomy for suspected ovarian cysts.

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The paper reports a 43-year-old multiparous woman who presented with one month of vaginal bleeding and lower abdominal pain, with ovaries that appeared enlarged and multicystic and cysts up to 3.0 cm. After hysterectomy and bilateral salpingo-oophorectomy performed for suspected ovarian cysts, histology showed lymphoplasmacytic infiltration around theca interna of developing, cystic, and atretic follicles, sparing primordial follicles, with infiltrate density increasing through follicular maturation and subsiding with involution; plasma cells were polyclonal and the infiltrate included both B and T lymphocytes. The authors note a limitation that autoantibodies and serum hormone levels were unknown. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

A case is described of an autoimmune oophoritis that was diagnosed unexpectedly after a hysterectomy and bilateral salpingo-oophorectomy had been performed on the suspicion of ovarian cysts. The patient was a 43-year-old multiparous woman who presented with vaginal bleeding and lower abdominal pain which she had had for one month. Grossly, the ovaries were enlarged and multicystic. The cysts measured up to 3.0 cm. The major histological change was a lymphoplasmacytic infiltrate in close relation to the theca interna of developing, cystic and atretic follicles, but sparing the primordial follicles. The infiltrate increased in density with the follicular maturation and culminated against the corpus luteum. With involution of the developing follicles, the inflammatory infiltrate subsided to some extent. The proportion of the plasma cells increased with the density of the infiltrates. Immunohistochemical study of the ovarian mononuclear cell infiltrate revealed a mixture of B- and T-lymphocytes. The plasma cells were polyclonal. These histological features of the present case are typical of autoimmune oophoritis although the presence of autoantibodies and hormonal level in the patient's serum were unknown. This case may be identified as in the early active stage of autoimmune oophoritis.
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Published online May 27, 2009. https://doi.org/10.3346/jkms.1992.7.3.284 Autoimmune oophoritis: a case report Abstract A case is described of an autoimmune oophoritis that was diagnosed unexpectedly after a hysterectomy and bilateral salpingo-oophorectomy had been performed on the suspicion of ovarian cysts. The patient was a 43-year-old multiparous woman who presented with vaginal bleeding and lower abdominal pain which she had had for one month. Grossly, the ovaries were enlarged and multicystic. The cysts measured up to 3.0 cm. The major histological change was a lymphoplasmacytic infiltrate in close relation to the theca interna of developing, cystic and atretic follicles, but sparing the primordial follicles. The infiltrate increased in density with the follicular maturation and culminated against the corpus luteum. With involution of the developing follicles, the inflammatory infiltrate subsided to some extent. The proportion of the plasma cells increased with the density of the infiltrates. Immunohistochemical study of the ovarian mononuclear cell infiltrate revealed a mixture of B- and T-lymphocytes. The plasma cells were polyclonal. These histological features of the present case are typical of autoimmune oophoritis although the presence of autoantibodies and hormonal level in the patient's serum were unknown. This case may be identified as in the early active stage of autoimmune oophoritis.

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