Histopathological Association Between Chronic Endometritis and Adenomyosis: Clinical Findings and Risk Factors
Batuhan Aslan1,2, Cevriye Cansız Ersöz3, Yavuz Emre Şükür1
1Department of Obstetrics and Gynecology Ankara University School of Medicine Ankara Turkey.
Reproductive Medicine and Biology
|September 24, 2025
Summary
Chronic endometritis (CE) is more common in adenomyosis patients. Basal endometrial loss may link CE and adenomyosis, suggesting CE as a therapeutic target for adenomyosis.
Area of Science:
- Gynecologic pathology
- Reproductive medicine
- Histopathology
Background:
- Chronic endometritis (CE) is an inflammatory condition of the uterine lining.
- Adenomyosis is a condition where endometrial tissue grows into the uterine muscle wall.
- The relationship between CE and adenomyosis, particularly basal endometrial changes, requires further investigation.
Purpose of the Study:
- To investigate the histopathological association between chronic endometritis (CE) and adenomyosis.
- To focus on basal endometrial alterations in adenomyosis.
- To explore the potential role of tissue injury and repair (TIAR) mechanisms.
Main Methods:
- Retrospective case-control study of 146 hysterectomy specimens (73 adenomyosis, 73 controls).
- CE diagnosed using CD38 immunohistochemical staining (≥5 plasma cells/HPF).
- Basal endometrial thickness and loss were digitally measured and defined.
Main Results:
- CE was significantly more frequent in the adenomyosis group (23.3%) vs. controls (9.6%; p=0.028).
- Basal endometrial loss was strongly associated with CE (47% vs. 7.1%; p<0.001).
- Basal endometrial loss was an independent risk factor for CE (aOR 10.45, p<0.001).
Conclusions:
- Chronic endometritis is significantly associated with adenomyosis.
- Basal endometrial loss may mediate the CE-adenomyosis relationship via TIAR mechanisms.
- CE represents a potential therapeutic target for adenomyosis.
Related Concept Videos
02:07Oogenesis
69.1K
In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
69.1K
01:24Disorders of the Female Reproductive System
3.9K
The female reproductive system can be affected by several disorders, including Premenstrual Syndrome (PMS), Premenstrual Dysphoric Disorder (PMDD), endometriosis, and various forms of cancer. PMS and PMDD are cyclical conditions that cause physical and emotional distress, with symptoms that include edema, mood swings, and food cravings. PMDD is a more severe form of PMS characterized by increased symptom severity that peaks during the luteal phase and tends to improve or resolve shortly after...
3.9K
01:19Histology of the Uterus
3.2K
The uterine wall consists of three histological layers: the perimetrium, myometrium, and endometrium. The outermost perimetrium is a thin, serous membrane connected with the broad ligament on the sides, which helps anchor the uterus in the pelvic cavity. The thickest layer, myometrium, is mainly made up of smooth muscle tissue bundles. Its contractions are vital in facilitating the expulsion of the uterine lining, fetus, and placenta during menstruation and childbirth.
The endometrium is the...
The endometrium is the...
3.2K
01:17Chronic Bowel Disorders: Introduction
747
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
747
01:22Appendicitis-I: Introduction
2.2K
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
2.2K
01:24Chronic Pancreatitis I: Introduction
667
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
667