図２〜図１５の嚢胞性病変（▲）は図１６の子宮に連続するので子宮由来の病変で，子宮内腔の液貯留を描出している可能性が高い．嚢胞性病変の壁は厚く，強く造影されることと，内容液はややdensityの高い部分を含み均一ではないことから子宮留膿腫（pyometra）と診断された．子宮頚管拡張により容易に排膿され治癒した．膿培養からE.coli が検出された．

参考症例（Plain CT，子宮留膿腫）：82歳女性．前日からの腰痛と発熱のため来院した．体温：39.0℃，下腹部に圧痛を認めた．
図２〜図７の嚢胞性病変（▲）は図８で子宮に連続するので子宮留膿腫である．頚管拡張・排膿で治癒した．細胞診などで悪性腫瘍の所見はなかった．膿培養：E.coli.

文献考察：子宮留膿腫.27例中悪性腫瘍によるものは22.2%，穿孔例は18.5%．
J Reprod Med. 2001 Nov;46(11):952-6.
Pyometra. What is its clinical significance?
Chan LY, Lau TK, Wong SF, Yuen PM.

OBJECTIVE: To evaluate the clinical outcomes of pyometra. STUDY DESIGN: Retrospective study conducted between 1993 and 1999 in two regional hospitals. RESULTS: Pyometra represented 0.038% of gynecologic admissions. Of the 27 women with pyometra, 6 (22.2%) cases were associated with malignancy, 1 (3.7%) was associated with genital tract abnormality, and 20 (74.1%) were idiopathic. Patients with idiopathic pyometra tended to be older and had a higher incidence of concurrent medical conditions. Five (18.5%) women experienced spontaneous perforation of pyometra. A preoperative diagnosis was correctly made in 17 of 22 (77.3%) patients without spontaneous perforation. Most women were treated with dilatation of the cervix and drainage. Nine women (33.3%) had persistent or recurrent pyometra; three of them were asymptomatic. CONCLUSION: Pyometra is an uncommon condition, but the incidence of associated malignancy is considerable, and the risk of spontaneous perforation is higher than previously thought. Dilatation and drainage is the treatment of choice, and regular monitoring after initial treatment is warranted to detect persistent and recurrent disease.　PMID: 11762150