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Infectious Diseases in Obstetrics and Gynecology
Volume 4, Issue 5, Pages 287-293

Immunohistochemical Characterization of Leukocytic Subpopulations in Chronic Endometritis

1Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas 66160, KS, USA
2Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas, KS, USA

Received 6 September 1996; Accepted 15 November 1996

Copyright © 1996 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective: We analyzed the histologic and immunohistochemical changes in the endometrial leukocytic subpopulations to determine which of them are characteristic of chronic endometritis.

Results: Endometrial biopsies from 25 cases of chronic endometritis and 35 controls were studied. Characteristic morphologic findings included the presence of a plasma cell infiltrate, and a prominent, albeit non-specific, lymphocytic infiltrate in all patients with endometritis. A neutrophilic infiltrate was also noted in 90% of the patients. Other non-specific histologic findings included occasional prominent lymphoid aggregates, stromal edema, hemorrhage, and necrosis and cystic dilation of some glands in endometria of patients with chronic endometritis. Endometrial immune cells were investigated immunohistochemically using antibodies to CD3 (pan-T), CD20 (pan-B, L26), and Ham-56 (macrophage). In control patients, endometrial immune cells were predominantly composed of CD3 and Ham-56 positive cells. CD20 positive cells comprised <2% of immune cells in control patients [mean: <2 cells/high power field (HPF)]. Large numbers of CD20 and CD3 lymphocytes were seen in endometria of patients with chronic endometritis. A semiquantitative analysis showed that the numbers of CD20 and CD3 positive cells in patients with chronic endometritis were increased 50- and 3-fold, respectively, when compared to those of control patients (mean B cells: 49 vs. 2 cells/HPF; mean T cells: 149 vs. 45 cells/HPF). CD20 positive cells were predominantly seen in subepithelial and periglandular aggregates. CD3 positive cells had a predominant stromal distribution and an occasional intra- or subepithelial localization. There was no difference in the number and distribution of Ham-56 positive cells in patients with or without endometritis.

Conclusions: These findings suggest that CD20 cells may have a significant role in the pathogenesis of chronic endometritis and that immunostaining for B and T lymphocytes could be used in confirming the diagnosis of endometritis or in diagnosing subclinical or progressing endometritis in which plasma cells could not be detected or are rarely identified.