RESUMEN
OBJECTIVE: To estimate if findings in women with chronic endometritis (CE) at fluid hysteroscopy correlate with the severity of inflammation at histology and to assess the possibility to score the severity of inflammation by fluid hysteroscopy. DESIGN: Controlled clinical study. SETTING: University hospital. POPULATION: A total of 211 outpatient women with a hysteroscopic diagnosis of CE and 30 control women without any such signs. METHODS: All patients underwent endometrial biopsy by means of a 3-mm Novak's curette connected to a 20-ml syringe without any anesthesia. MAIN OUTCOME MEASURES: Hysteroscopic records were reviewed and compared with histologic findings by using an arbitrary inflammation score (Grades 0-2, no inflammation to severe infiltration, nodules and glands disruption, respectively). RESULTS: A significant correlation between focal hyperemia and isolated micropolyps with Grade 1 inflammation and between generalized hyperemia, presence of diffuse micropolyps and polypoid endometrium with Grade 2 inflammation was found. Hysteroscopic and histologic grading showed good agreement (kappa index = 0.62). CONCLUSIONS: In women affected by CE the severity of histological alterations may be reliably evaluated by fluid hysteroscopy. This information may be clinically useful not only for giving a prognosis and as a basis for interpretation of patients' complaints, but also for monitoring treatment.
Asunto(s)
Endometritis/patología , Endometrio/patología , Histeroscopía , Biopsia con Aguja Fina , Estudios de Casos y Controles , Enfermedad Crónica , Endometritis/clasificación , Femenino , Humanos , Hiperemia/patología , Pólipos/patología , Índice de Severidad de la EnfermedadRESUMEN
Chronic endometritis is an inflammatory condition of the uterus and is characterized by the presence of plasma cells in the endometrium. This disorder may be discovered when an endometrial biopsy is performed to evaluate hormonal therapy, abnormal vaginal bleeding or other conditions. If the specific etiology of chronic endometritis (e.g., infection with Chlamydia trachomatis or a postpartum state) can be determined, appropriate treatment should be initiated. However, empiric treatment is often required, since the etiology of chronic endometritis frequently is unclear. Treatment consists of antimicrobial therapy and hormonal manipulation.
Asunto(s)
Endometritis , Enfermedad Crónica , Árboles de Decisión , Endometritis/clasificación , Endometritis/diagnóstico , Endometritis/etiología , Endometritis/terapia , Femenino , Humanos , PrevalenciaRESUMEN
A 52-year-old woman with vaginal bleedings had hysterectomy because curettings prompted suspicion of malignancy. A uterine tumour with deep infiltration of trophoblastic cells in the myometrium was revealed. Postoperative quantitative analysis for urinary human choriongonadotropin gave 1500 IU/1. The patient got no other treatment and is well 3 years after operation. The histopathological picture and the clinical course were consistent with the recently introduced diagnosis of benign "trophoblastic pseudotumour", which should perhaps replace the old terms "syncytioma" and "chorionepitheliosis".