Immunohistochemical Evaluation of Chronic Endometritis by CD138, CD3 and CD20
Keywords:
Endometritis, Abnormal uterine bleeding, Immunohistochemistry, Histopathology
Abstract
Background: Chronic inflammation of endometrium is often clinically silent but may present as abnormal uterine bleeding, dyspareunia, infertility, leucorrhoea and sometimes urinary symptoms. The diagnosis is often rendered on histopathological examination of endometrial biopsy showing chronic inflammatory infiltrate in general and plasma cells in particular. In order to identify scant plasma cells and lymphocytes in the chronic endometritis, immunohistochemistry is increasing being used to confirm the diagnosis. Aims and objectives: To study the utility of panel of CD3, CD20 and CD 138 in the evaluation of chronic endometritis in cases of abnormal uterine bleeding and infertility and correlate the result of immunohistochemistry with routine H & E staining. Method and Material: 100 consecutive cases of abnormal uterine bleeding and infertility were taken and histopathological diagnosis was made. IHC with all the three markers were applied in all the cases irrespective of histopathological diagnosis. Results: A total of 100 cases of endometrial currettings and biopsies were studied who presented with AUB. 17 cases were diagnosed as chronic endometritis purely on histopathology while 8 additional cases were identified with help of immunohistochemistry. Two cases diagnosed on histopathology were negative on immunohistochemistry. Out of all the three markers CD 138 was the most specific while CD 3 was least specific in diagnosing chronic endometritis. Conclusion: Immunohistochemistry particularly CD 138 is very useful in suspected cases of chronic endometritis particularly in cases where histopathology does not show any evidence of chronic inflammation.References
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11. Crum CP, Egawa K, Fenoglio CM, Richart RM. Chronic endometritis: The role of immunohistochemistry in the detection of plasma cells. Am J Obstet Gynecol 1983; 147: 812-5.
12. Bayer Garner IB, Korourian S. Plasma cell in chronic endometritis are easily identified when stained with syndecan 1. Mod Pathol 2001;14: 877-9.
13. Bancroft J, Layton C. The hematoxylins and eosin. In: Bancroft J, Layton C, Suvarna SK editors. Bancroft‟s Theory and practice of histological techniques. 7th ed. Philadelphia: Elsevier; 2013p173-86.
14. Vicetti Miguel RD, Chivukula M, Krishnamurti U, Amortegui AJ, Kant JA, Sweet RL,et al . Limitations of the criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease research. Pathol Res Pract 2011; 207: 680-5.
15. Kannar V, Lingaiah HKM, Sunita V. Evaluation of endometrium for chronic endometritis by using syndecan 1 in abnormal uterine bleeding. J Lab Physicians 2012 ; 4: 69-73.
16. Kitaya K, Yasuo T. Immunohistochemistrical and clinicopathological characterization of chronic endometritis. Am J Reprod Immunol 2011; 66: 410-5.
17. Chen Y, Fang R, Luo Y, Luo CQ, Analysis of the diagnostic value of CD138 for chronic endometritis, the risk factors for the pathogenesis of chronic endometritis and the effect of chronic endometritis on pregnancy: A cohort study. BMC Women's Health 2016;16 :60-7.
18. Disep B, Innes BA, Cochrane HR, Tijani S, Bulmer JN. Immunohistochemical characterization of endometrial leucocytes in endometritis. Histopathology 2004; 45: 625-32.
19. Tawfik O, Venuti S, Brown S, Collins J.Immunohistochemical characterisation of leukocytic subpopulations in chronc endometritis. Infect Dis Obstet Gynecol. 1996;4:287–93.
2. Greenwood SM, Moran JJ. Chronic endometritis: morphologic review references and clinical observations. Obstet Gynecol 1981; 58: 176-83.
3. Crum CP, Egawa K, Fenoglio CM, Richart RM. Chronic endometritis: The role of immunohistochemistry in the detection of plasma cells. Am J Obstet Gynecol 1983;147: 812-5.
4. Farooki MA. Epidemiology and pathology of chronic endometritis. Int Surg 1967; 48: 566-73.
5. Pitsos M, Skurnick J, Heller D. Association of pathologic diagnoses with clinical findings in chronic endometritis. J Reprod Med 2009; 54:373-7.
6. Bulmer JN, Lunny DP, Hagin SV. Immunohistochemical characterization of stromal leukocytes in nonpregnant human endometrium. Am J Reprod Immunol Microbiol 1988;17: 83-90.
7. King A, Wellings V, Gardner L, Loke YW. Immunohistochemical characterization of the unusual large granular lymphocytes in human endometrium throughout the menstural cycle. Hum Immunol 1989; 24:195-205.
8. Poropatich C, Rojas M, Silverberg SG. Polymorphonuclear leukocytes in the endometrium during the normal menstrual cycle. Int J Gynecol Pathol 1987; 6:230-4.
9. Marshall RJ, Jones DB. An immunohistochemical study of lymphoid tissue in human endometrium. Int J Gynaecol Pathol 1988; 7: 225-35.
10. Andrews WW, Hauth JC, Cliver SP, Conner MG, Goldenberg RL, Goepfert AR. Association of asymptomatic bacterial vaginosis with endometrial microbial colonization and plasma cell endometritis in nonpregnant women. Am J Obstet Gynecol 2006; 195:1611-6.
11. Crum CP, Egawa K, Fenoglio CM, Richart RM. Chronic endometritis: The role of immunohistochemistry in the detection of plasma cells. Am J Obstet Gynecol 1983; 147: 812-5.
12. Bayer Garner IB, Korourian S. Plasma cell in chronic endometritis are easily identified when stained with syndecan 1. Mod Pathol 2001;14: 877-9.
13. Bancroft J, Layton C. The hematoxylins and eosin. In: Bancroft J, Layton C, Suvarna SK editors. Bancroft‟s Theory and practice of histological techniques. 7th ed. Philadelphia: Elsevier; 2013p173-86.
14. Vicetti Miguel RD, Chivukula M, Krishnamurti U, Amortegui AJ, Kant JA, Sweet RL,et al . Limitations of the criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease research. Pathol Res Pract 2011; 207: 680-5.
15. Kannar V, Lingaiah HKM, Sunita V. Evaluation of endometrium for chronic endometritis by using syndecan 1 in abnormal uterine bleeding. J Lab Physicians 2012 ; 4: 69-73.
16. Kitaya K, Yasuo T. Immunohistochemistrical and clinicopathological characterization of chronic endometritis. Am J Reprod Immunol 2011; 66: 410-5.
17. Chen Y, Fang R, Luo Y, Luo CQ, Analysis of the diagnostic value of CD138 for chronic endometritis, the risk factors for the pathogenesis of chronic endometritis and the effect of chronic endometritis on pregnancy: A cohort study. BMC Women's Health 2016;16 :60-7.
18. Disep B, Innes BA, Cochrane HR, Tijani S, Bulmer JN. Immunohistochemical characterization of endometrial leucocytes in endometritis. Histopathology 2004; 45: 625-32.
19. Tawfik O, Venuti S, Brown S, Collins J.Immunohistochemical characterisation of leukocytic subpopulations in chronc endometritis. Infect Dis Obstet Gynecol. 1996;4:287–93.
Published
2019-08-26
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