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Histopathology of Chronic Endometritis
• CE characterized by infiltration of plasmacytes within the endometrial stroma
• In parallel with stromal plasmacyte infiltration, the endometrial functional layer in CE is invaded by B cells.
• B cells, a rare leukocyte subset residing within the basal layer in the nonpathological endometrium (that persists across the menstrual cycle) as central cells in the unique lymphocyte aggregates surrounded by numerous CD8(+) T cells and macrophages (Yeaman GR et al., J Leukoc Biol 1997; 61:427– 35).
• These overpopulated B cells amass in the endometrial stromal compartment, trespass on the glandular epithelial areas, and invade further into the gland lumina (Kitaya et al., 2010)
Histology: Gold standard for diagnosis of CE
• The diagnosis of chronic endometritis relies on identification of plasma cells in the endometrial stroma.
• Lymphocytes, neutrophils, histiocytes, and eosinophils, generally not diagnostic for endometritis, because they are normal constituents of the stroma.
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