Pseudoxanthomatous and xanthogranulomatous salpingitis of the fallopian tube: a report of four cases and a literature review.

The clinical and pathological features of four cases of pseudoxanthomatous salpingitis (PXS) and xanthogranulomatous salpingitis (XGS) are described. The women with PXS underwent salpingectomy for primary sterility (Case 1) and endometriosis (Case 2). The two women with XGS presented with pelvic inflammatory disease (PID) and an adnexal mass and were initially treated with antibiotics. Shortly thereafter, a left salpingo-oophorectomy (Case 3) and total abdominal hysterectomy with bilateral salpingo-oophorectomy (Case 4) were performed. In Cases 1 and 2, histological examination revealed expansion of the tubal plicae with numerous pigmented histiocytes (PXS). In Cases 3 and 4, the tubal mucosa was infiltrated by foamy histiocytes admixed with other inflammatory cells (XGS). A review of the literature revealed that most patients with PXS have a clinical history of long-standing endometriosis, whereas XGS is an unusual manifestation of chronic PID. Although PXS can be confused on histological examination with XGS, the two processes should be distinguished because of their different clinical associations and pathogenesis.