Immunohistochemistrical and clinicopathological characterization of chronic endometritis.

PROBLEM: Chronic endometritis is an elusive entity that is often asymptomatic and undetectable by conventional endometrial biopsy and histological examination. Using immunohistochemistry for full-thickness endometrium, we sought for its clinicopathological features.

METHOD OF STUDY: Two hundred and thirty-four archival endometrial specimens obtained by hysterectomy were immunostained for the plasmacyte marker syndecan-1 to identify chronic endometritis. Endometrial morphology was dated by the standard criteria. The immunoreactive cells were enumerated in 10 non-overlapping endometrial stromal areas. The clinical parameters were obtained from the medical charts.

RESULTS

Chronic endometritis was identified in 11.1% of the samples examined. Its occurrence was similar between the proliferative phase and secretory phase. A total of 23.1% of the cases were asymptomatic. Stromal plasmacyte infiltration and morphological delay were more prominent in symptomatic chronic endometritis than in asymptomatic counterpart.

CONCLUSIONS

Chronic endometritis is a common gynecological pathological condition and more often asymptomatic than ever expected. There was no menstrual cycle-dependent fluctuation in its occurrence.