Damage Control Management of Perforating Pyometra Presenting with Septic Shock after the Return of Spontaneous Circulation

Figure 5

Pathological findings. (a) Appearance of pyometra. (b) A solid white mass of approximately 10 cm in size, and yellowish fragile areas with necrosis or abscess formation in the mass (circles). (c) Histologically, there was no obvious malignancy. There were few positive findings of smooth muscle markers (SMA, Caldesmon) using immunostaining. Deposition of collagen fiber bundles was relatively prominent in the stroma, and a flower bud-like array was recognized. These findings suggested that this mass was a fibroma rather than a leiomyoma. An abscess with massive neutrophil infiltration was present in the mass, and the surrounding serosal surface showed inflammatory cell infiltration with fibrin deposition. (d) A large mass of Gram-positive bacteria (arrowheads) was found inside the abscess.