Endometrial Glands with Mucinous Metaplasia in the Setting of Chronic Endometritis: A Newly Described Finding
Previn Y Gulavita, Bojana Djordjevic. University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
Background: Mucinous metaplasia is a rare phenomenon in non-neoplastic endometrium. For the first time, we present a case series of mucinous endometrial metaplasia in the setting of chronic endometritis.
Design: We reviewed 77 endometrial biopsies and curettings with chronic endometritis from our institution over a period of 4 years. The histological diagnosis of endometritis was made by establishing the presence of inflammatory cells in the endometrial stroma including plasma cells and any lymphocytes, eosinophils or neutrophils. Presence of endometrial stroma was confirmed with CD10 staining. Mucinous metaplasia in the involved endometrial glands was confirmed with mucicarmine and Alcian blue (pH2.5) staining.
Results: Endometritis was diagnosed in a number of clinical settings, including 44 cases of recent pregnancy with retained products of conception, 28 cases of intrauterine contraceptive device use, 3 cases of uterine leiomyomata, 1 case of uterovaginal prolapse, and 1 case of endometrial hyperplasia. Of these cases, we identified 3 with mucinous metaplasia of endocervical type. Two of these cases were in the setting of dilation and curettage for retained products of conception, and 1 in the setting of intrauterine contraceptive device use. In all 3 cases, mucinous metaplasia was a focal finding.
Conclusions: Mucinous endometrial metaplasia is uncommonly seen in endometritis. In endometrial biopsies, it may be confused with endocervical glands. As diagnosis of endometritis often relies on identification of plasma cells, which may be difficult to detect, awareness of the possibility of mucinous endometrial metaplasia in endometritis may be a useful diagnostic aid.
Category: Gynecologic & Obstetrics
Monday, March 19, 2012 9:30 AM
Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 172, Monday Morning