Correlation between hysteroscopy findings and chronic endometritis

Area of Science:

• Reproductive Medicine
• Gynecologic Pathology
• Diagnostic Imaging

Background:

• Chronic endometritis (CE) is a persistent inflammation of the uterine lining.
• Accurate diagnosis of CE is crucial for reproductive health outcomes.
• Hysteroscopy is a minimally invasive procedure used to visualize the uterine cavity.

Purpose of the Study:

• To evaluate the diagnostic role and accuracy of hysteroscopy in identifying chronic endometritis (CE).
• To assess the correlation between hysteroscopic findings and histological confirmation of CE.

Main Methods:

• A retrospective cohort study of 1,189 patients undergoing diagnostic hysteroscopy.
• Endometrial biopsy specimens were collected post-hysteroscopy for histology and CD138 immunohistochemistry to detect plasma cells.
• Analysis of hysteroscopic features (hyperemia, edema, micro-polyps) and their correlation with CD138 positivity.

Main Results:

• CD138-positive plasma cells, indicative of CE, were found in 27.1% of cases.
• Hysteroscopic features like endometrial hyperemia (52.5%) and micro-polyps (3.4%) were observed in CE cases.
• The overall diagnostic accuracy of hysteroscopy for CE was 66.9%, with a sensitivity of 59.3% and specificity of 69.7%.

Conclusions:

• Hysteroscopic findings such as endometrial hyperemia, micro-polyps, or edema can raise suspicion for CE.
• Hysteroscopy alone has limited accuracy (67%) and should not replace histological examination for CE diagnosis.
• Endometrial biopsy with CD138 immunohistochemistry remains the preferred diagnostic method for chronic endometritis.