Xanthogranulomatous appendicitis causing an endometrial abscess: radiological findings

Area of Science:

• Pathology
• Radiology
• Gastroenterology

Background:

• Xanthogranulomatous inflammation (XGI) is a rare chronic inflammatory condition, typically affecting the kidneys and gallbladder.
• Histopathologically, XGI is defined by the presence of foamy histiocytes, lymphocytes, and plasma cells.
• While appendicitis due to XGI has been reported, its specific imaging characteristics remain understudied.

Observation:

• This report details a pathologically confirmed case of xanthogranulomatous appendicitis (XGA) with associated uterine and right adnexal involvement.
• The patient underwent a comprehensive radiological evaluation, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI).
• The presentation mimicked a complicated pelvic abscess on radiological imaging.

Findings:

• This is the first reported case of XGA involving the appendix, uterus, and right adnexa.
• The study emphasizes the radiological appearance of XGA presenting as a complex pelvic abscess.
• Detailed imaging findings from US, CT, and MRI are presented for this rare condition.

Implications:

• This case expands the known spectrum of XGI manifestations.
• Understanding the radiological features of XGA is crucial for accurate diagnosis and management.
• Further research into the imaging characteristics of XGA is warranted to improve diagnostic accuracy.