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Difference between revisions of "Endometritis"
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'''Endometritis''' is inflammation of the [[endometrium]]. It usually subdivided into ''acute'' and ''chronic''. | |||
==General== | |||
*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. | |||
==See also== | |||
*[[Endometrium]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Endometrium]] | |||