Chronic Endometritis: Histomorphologic Features and Plasma Cell Marker Correlation in Endometrial Curettage Specimens
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Chronic endometritis is a subtle inflammatory disorder of the endometrium characterized by stromal plasma-cell infiltration, the recognition of which remains challenging in routine histopathologic evaluation. The present study aimed to evaluate the histomorphologic features of chronic endometritis in endometrial curettage specimens and to assess their correlation with plasma-cell burden using CD138 and MUM1 immunohistochemistry. A retrospective analysis was performed on 40 endometrial curettage specimens. Histomorphologic features were assessed on hematoxylin-eosin sections, and plasma-cell infiltration was quantified using hotspot and average counts per 10 high-power fields for both CD138 and MUM1. Statistical analysis was performed using descriptive methods and Spearman correlation. The mean age of the cohort was 38.95 ± 8.64 years. Stromal edema, increased stromal cellularity, and surface epithelial changes were each present in 80.0% of cases, while periglandular inflammation, diffuse inflammation, and hemorrhage were observed in 60.0% of cases. All specimens demonstrated positivity for both CD138 and MUM1, with variable plasma-cell burden. A strong correlation was observed between CD138 and MUM1 average counts (ρ = 0.787, p < 0.001). Lymphoplasmacytic infiltrate showed the strongest association with plasma-cell burden (CD138: ρ = 0.866; MUM1: ρ = 0.884; p < 0.001). Periglandular and diffuse inflammation were also significantly associated with increased plasma-cell counts, whereas stromal edema did not demonstrate a significant correlation. These findings indicate that specific histomorphologic features, particularly lymphoplasmacytic infiltrate and gland-associated inflammation, are closely related to plasma-cell burden. Combined assessment using CD138 and MUM1 provides a consistent evaluation of plasma-cell infiltration and supports their complementary role in the diagnostic assessment of chronic endometritis.
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