case_images: PMC11183279_01
case_images: (A) A colposcopic image at the time of initial diagnosis; the arrow points to the lesion. (B) Review of the colposcopic image in the second month of treatment; the arrow points to the lesion.
case_images: fmed-11-1409239-g0001.jpg
case_images: PMC11183279_01_fmed-11-1409239-g0001.jpg
case_images: F1
case_images: The outpatient department was highly suspicious of a cervical malignant tumor, so further colposcopy (Figure 1A) and tissue biopsy were performed. After one month of treatment, the vaginal bleeding of the patient stopped, the colposcopy mass was smaller than before, and the focus was limited to the cervical surface in the second month (Figure 1B).
case_images: Sagittal T2 (A), sagittal T1 enhancement (B) and coronal T2 (C) images all show a large cervical mass protruding into the vagina, with a size of approximately 50 * 58 * 91 mm. The mass invaded the cervical interstitium (black arrow), and the surrounding low-signal basal ring was still apparent. In (B), and the lesion appeared in the vagina, occupying 2/3 of the vaginal cavity (red arrow). The uterine body was compressed and moved upward.
case_images: fmed-11-1409239-g0002.jpg
case_images: PMC11183279_01_fmed-11-1409239-g0002.jpg
case_images: F2
case_images: Pelvic magnetic resonance imaging (MRI) revealed a large cervical space occupying the protrusion into the vagina; this space was thought to be a result of malacoplakia, although cervical malignancies were not excluded (Figure 2).
case_images: Pathological images of cervical lesions. Microscopy revealed a diffuse inflammatory lesion with a large number of tissue cell clusters [(A), 100X]. In the background of tissue cells, there were varying numbers of plasma cells and lymphocytes, and there may have been bleeding and a small amount of neutrophils [(B), 100X]. Characteristic soft spot bodies (Michaelis Gutmann bodies, MG bodies) were also observed inside and outside the tissue cells. Soft spot bodies were round or oval in shape, with clear boundaries, refractive, alkaline homogeneous shapes, or ring-like structures resembling "owl's eyes" [(C), 400X]. MG bodies are formed by incomplete degradation of bacterial calcification. Immunohistochemistry revealed CD68- and CD163-positive tissue cells [(D, E), 200X), while PAS staining revealed purplish red soft macular bodies [(F), 400X].
case_images: fmed-11-1409239-g0003.jpg
case_images: PMC11183279_01_fmed-11-1409239-g0003.jpg
case_images: F3
case_images: Microscopy revealed a diffuse inflammatory lesion with a large number of tissue cell clusters (Figure 3A, 100X). In the background of tissue cells, there were varying numbers of plasma cells and lymphocytes, and there may have been bleeding and a small amount of neutrophils (Figure 3B, 100X). Soft spot bodies were round or oval in shape, with clear boundaries, refractive, alkaline homogeneous shapes, or ring-like structures resembling "owl's eyes" (Figure 3C, 400X). Immunohistochemistry revealed CD68- and CD163-positive tissue cells (Figures 3D, E, 200X), while PAS staining revealed purplish red soft macular bodies (Figure 3F, 400X).