Difference between revisions of "Endometrium"

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Endometrium (view source)

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==Endometritis==
==Endometritis==
===General===
{{Main|Endometritis}}
*Usually post-delivery or post-instrumentation, e.g. previous biopsy.
*May be spontaneous, e.g. tuberculous endometritis.
 
===Microscopic===
====Acute endometritis====
Features:
*Neutrophils clusters (>5 PMNs) in the:
**Endometrial stroma.
**Within uterine glands.
 
Notes:
*Neutrophils are normal in the context of menses.
 
Image:
*[http://www.hsc.stonybrook.edu/gyn-atlas/UT53.10.1.htm Acute endometritis (stonybrook.edu)].
 
====Chronic endometritis====
Features:<ref name=pmid18476109>{{Cite journal  | last1 = Tawfik | first1 = O. | last2 = Venuti | first2 = S. | last3 = Brown | first3 = S. | last4 = Collins | first4 = J. | title = Immunohistochemical characterization of leukocytic subpopulations in chronic endometritis. | journal = Infect Dis Obstet Gynecol | volume = 4 | issue = 5 | pages = 287-93 | month =  | year = 1996 | doi = 10.1155/S1064744996000555 | PMID = 18476109 | PMC = 2364507 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2364507/}}</ref>
*Plasma cells with in the endometrial stroma - '''key feature'''.
**Usually superficial/close to the luminal aspect.
*Lymphocytic infiltrate - usually marked.
**May form lymphoid aggregates - '''low power''' finding.
*+/-Eosinophils - presence should prompt a search for plasma cells.<ref name=pmid19801162>{{Cite journal  | last1 = Adegboyega | first1 = PA. | last2 = Pei | first2 = Y. | last3 = McLarty | first3 = J. | title = Relationship between eosinophils and chronic endometritis. | journal = Hum Pathol | volume = 41 | issue = 1 | pages = 33-7 | month = Jan | year = 2010 | doi = 10.1016/j.humpath.2009.07.008 | PMID = 19801162 }}</ref>
 
Other findings:<ref name=pmid18476109/>
*+/-Necrosis.
*Edema - common.
*Hemorrhage.
 
Notes:
*One [[plasma cell]] is not enough to call it.
 
DDx:
*Mentrual endometrium - endometrial stromal condensation.
 
====Images====
<gallery>
Image:Endometritis_-_2_-_high_mag.jpg | Endometritis - high mag. (WC/Nephron)
Image:Endometritis_-_2_-_cropped_-_very_high_mag.jpg | Endometritis - very high mag. (WC/Nephron)
</gallery>
www:
*[http://www.webpathology.com/image.asp?n=2&Case=565 Chronic endometritis (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=3&Case=565 Chronic endometritis (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=6&Case=565 Tuberculous endometritis (webpathology.com)].
 
===Sign out===
<pre>
ENDOMETRIUM, BIOPSY:
- CHRONIC ENDOMETRITIS.
</pre>
 
====Not definite endometritis====
<pre>
ENDOMETRIUM, ASPIRATION:
- PROLIFERATIVE PHASE ENDOMETRIUM WITH A MILD LYMPHOCYTIC INFILTRATE AND VERY RARE
  PLASMA CELLS, SEE COMMENT.
- NEGATIVE FOR HYPERPLASIA.
 
COMMENT:
The lymphocytic infiltrate and plasma cells raise the possibility of a mild chronic
endometritis; clinical correlation is suggested.
</pre>
 
====Nonspecific lymphocytic infiltrate====
If not more than one plasma cell is apparent after searching.
<pre>
ENDOMETRIUM, ASPIRATION:
- PROLIFERATIVE PHASE ENDOMETRIUM WITH A MILD LYMPHOCYTIC INFILTRATE.
- SMALL FRAGMENT OF ENDOCERVICAL MUCOSA WITHIN NORMAL LIMITS.
- NEGATIVE FOR HYPERPLASIA.
</pre>
 
=====Micro=====
The section show proliferative endometrium with a normal gland-to-stroma ratio.  Mitotic activity is seen in the glands and stroma. No cytologic atypia is apparent. A mild nonspecific lymphocytic infiltrate is present.
 
No lymphoid aggregates are apparent. No eosinophils are apparent. No significant number of plasma cells is apparent.
 
======Alternate======
The sections show a fragmented nonproliferative endometrium with stromal decidualization
and focal glandular dilation. The gland-to-stroma ratio is within normal limits. No
cytologic atypia is apparent.
 
Lymphoid aggregates are present. Focally, rare eosinophils are identified. No significant
number of plasma cells is apparent.


==Benign endometrial polyp==
==Benign endometrial polyp==
Michael
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