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Joint endoprosthesis lymphadenopathy mimicking lymph node involvement in a patient with endometrial carcinoma

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Case

A 62-year-old nullipara was referred for hysterectomy and staging of endometrial carcinoma. She had bilateral total hip joint replacement 22 years previously. Abdominal exploration found bilateral, enlarged, pelvic lymph nodes up to 2.5 cm in diameter. Hysterectomy with bilateral salpingo-oophorectomy and systematic pelvic lymphadenectomy were done. Results of frozen section analysis of the pelvic nodes were negative.

Histologically the lymph nodes had a histiocytic reaction with infiltration of

Comment

Total hip joint endoprothesis can be surrounded by a secondary capsule, which is a noninfectious, inflammatory mesenchymal reaction to particles sloughed off the prosthesis and cement materials. Incidence and extent of this reaction increases with time. Histologic analysis shows cytoplasma-rich histiocytes with phagocytosed foreign bodies consisting mainly of sloughed particles of the two major components of the bone cement, namely polymethylmethacrylate and zinc oxide. Bos et al3 described

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