Cholesterol granulomas in lymph nodes draining a benign ovarian neoplasm
Grignon, D.J.; Kirk, M.E.; Haines, D.S.
Archives of Pathology and Laboratory Medicine 109(12): 1124-1126
1985
ISSN/ISBN: 0003-9985 PMID: 3840989 Document Number: 249732
A 69-year-old woman underwent a hysterectomy and bilateral salpingo-oophorectomy for a 20-cm right ovarian tumor. Multiple peritoneal and lymph node biopsy specimens were obtained to determine the clinical stage. Despite the surgeon's concern of malignancy, pathologic examination demonstrated a benign mucinous cystadenoma. Periaortic and external ilial lymph nodes showed an unusual granulomatous reaction, with multinucleated giant cells surrounding cholesterol-like clefts. Analysis of cyst fluid from the ovarian tumor revealed high concentrations of protein and lipid; the lipid component was predominantly free cholesterol (0.61 .mu.mole/mL) and phospholipid (0.225 .mu.mole/mL). We speculate that fluid from the ovarian neoplasm drained into regional lymph nodes, causing this unusual granulomatous response.